A network meta-analysis of 38 randomized controlled trials found that percutaneous electrolysis was most effective for pain reduction in lateral epicondylitis (tennis elbow), while dry needling showed the highest probability for functional improvement within 3 months.
- Percutaneous electrolysis ranked highest for pain relief (SUCRA = 98.5%)
- Dry needling was most effective for restoring elbow function
- Both treatments outperformed standard conservative care in short-term outcomes
How this compares to prior research
Lateral epicondylitis is a well-recognized chronic tendon disorder affecting the elbow, but optimal treatment selection has remained unclear. While various physical interventions including injections, electrolysis, and needling techniques have been used clinically, prior research had not systematically compared their relative effectiveness for both pain relief and functional recovery. This network meta-analysis addresses that gap by simultaneously evaluating multiple treatment options across standardized outcome measures.
Lateral epicondylitis prevalence among adults, global estimates, 1980–1989
Key findings
- Percutaneous electrolysis achieved the highest ranking for pain reduction with a SUCRA score of 98.5% and reduced pain by 6.00 points on the VAS scale compared to baseline care
- Dry needling demonstrated the strongest functional improvement, ranking highest on both DASH (79.7%) and PRTEE (85.2%) scales, with a 25.04-point improvement over conservative care
- Other common treatments including platelet-rich plasma and corticosteroid injections showed only moderate effectiveness in the short-term
What this means in practice
- Ask your doctor about percutaneous electrolysis if your primary concern is rapid pain relief from tennis elbow
- Consider dry needling if your main goal is to restore your ability to use your elbow for daily activities
- Discuss your specific symptoms with your provider to choose between pain-focused or function-focused treatment approaches
Frequently asked questions
What is lateral epicondylitis?
Lateral epicondylitis, commonly called tennis elbow, is a chronic tendon condition affecting the outer elbow that causes pain and impairs arm function and quality of life. For patients managing chronic conditions, incorporating Evidence Based Treatment Chronic Pain strategies alongside preventive nursing can significantly reduce fall risk.
How long do these treatments take to work?
This study evaluated short-term results within 3 months of treatment. The authors note that long-term effectiveness requires further research before definitive recommendations can be made.
Should I choose treatment based on pain or function?
The authors recommend tailoring treatment to your primary symptom: choose percutaneous electrolysis if immediate pain relief is the priority, or dry needling if restoring elbow function is more important.
Key terms explained
Percutaneous electrolysis
A minimally invasive technique using electrical current applied through a needle to treat damaged tendon tissue
SUCRA score
Surface Under the Cumulative Ranking curve; a probability measure ranking treatments from 0-100%, with higher scores indicating better performance
Network meta-analysis
A statistical method that simultaneously compares multiple treatments by combining direct and indirect evidence from different studies
Source: Short-term efficacy of physical interventions for lateral epicondylitis: a network meta-analysis based on multidimensional evaluation of pain and function. · DOI: doi: 10.3389/fpain.2026.1855508