Mulligan's Mobilization with Movement and Muscle Trigger Point Dry Needling for the Management of Chronic Lateral Epicondylalgia: A Case Report

• Published in: Journal of musculoskeletal pain 2009-11, Vol.17 (4), p.409-415
• Main Authors: Fernández-Carnero, Josue, Fernández-de-las-Peñas, Cesar, Cleland, Joshua A.
• Format: Article
• Language: English
• Subjects: Elbow; Lateral epicondylalgia; mobilization-with-movement; Motor ability; Musculoskeletal system; Pain; pain threshold; Patients; trigger point dry needling
• ISSN: 1058-2452; 2470-8593; 1540-7012; 2470-8607
• DOI: 10.3109/10582450903284802

Background: It has been found that trigger points [TrPs] in the extensor carpi radialis brevis [ECRB] muscle reproduce pain in lateral epicondylalgia [LE]. Trigger point dry needling [TrP-DN] has not been previously investigated in LE. Findings: A female LE patient with duration of six years received eight treatments [TrP-DN in the ECRB muscle and a mobilization-with-movement technique] in a four-week period. The outcome measures of the patient-rated tennis elbow evaluation [PRTEE], pain-free grip force [PFG], visual analogue scale, and pressure-pain threshold [PPT] were taken pre- and post-intervention and at one-month and four-month follow-ups. The PPT increased from 248 to 609 kPa at the end of the treatment period. Elbow pain showed a substantial improvement from 7/10 at the pre-treatment to 0/10 after the four-week intervention period. PFG values increased from 12 to 28 kg after the treatment period. After the treatment, all values of the PRTEE questionnaire were 0, suggesting a rapid recuperation of elbow function following the intervention. Conclusions: Our findings suggest that the TrP-DN and mobilization-with-movement combination may be suitable for the restoration of motor function and the induction of a hypoalgesic effect in LE.