Category Archives: Elbow Pain

Acupuncture – how does it work? And will it cure Man-Flu?

A lot of people ask us about acupuncture. Not only the obvious things like: Does it hurt? How big are the needles? But also, How does it work? And, Will it help my sciatica/mood/tight muscles?

Sensible questions all round! Here, we try to provide some (mostly sensible) answers. Watch out for the science (anyone else remember Jennifer Aniston in the L’Oreal advert?) Let’s start at the beginning.

What is Acupuncture?

It’s the insertion of very thin needles into specific points on the skin. Part of Chinese medicine that’s been around for over 2000 years, it has been used commonly in Western societies since the 1970s. Physiotherapists use acupuncture for many different purposes, but the main ones are: to relieve pain, to reduce muscle tension, and to promote the body’s own healing processes as an accompaniment to other treatments such as manual therapy and relaxation teachniques.

Acupuncture (Copyright First Class Physiotherapy 2014)How Does Acupuncture Work?

*Science bit* By creating a very small and controlled amount of “sterile trauma” with the needle, acupuncture stimulates the body to produce endorphins (happy/pain-relieving hormones) and their receptors (which means not only do you have more hormone to create an effect, you also have a greater catchment area to “feel” that effect), as well as serotonin (stress-busters). The needle also stimulates A? nerve fibres. This produces another chemical which blocks the C fibres – the nerve endings for PAIN – from accepting input. Long story short: you swap the pain sensation for something more like a tingling or a heaviness, or a nice relaxed feeling instead.

Does it Hurt?

Well, not any more than you might expect from a very small needle (each one is about the width of a human hair). And quite often, a whole lot less than you’d expect. It depends what area we’re working on. Some parts of the body have more concentrated nerve endings per unit area, and these will natually be more sensitive (your hands and feet, for example). Some have fewer nerve endings (thighs, back etc). If there is a lot of muscle tension in the area, you can get a very strong sensation but conversely, you may not feel the needle at all.

So What Will I Feel?

Alongside the tingling or warm, heavy feeling, you may feel a little sleepy or even giggly (this one more common in men in my experience). Some people feel a little light-headed, and there can be side-effects that aren’t as much fun, like nausea or fainting. Usually the treatment won’t feel unpleasant at all, but if you don’t wish to proceed at any time, we’ll take the needles out immediately. ( (

Where Will the Needles Be Put?

This will depend on what your symptoms are and where you feel them. Because of the way the channels are lined up in your body and along your limbs (think of them kind of like a long train track with lots of stations along it), you wouldn’t necessarily have to have the needles exactly where your pain is to still get a good effect. There are some points that are usually used in conjunction with others (called “formula” points), for instance the “4 gates”, which are points in both hands and both feet and help relieve pain. And there are points away from the spine, as well as closer to the spine on those “tracks” or Meridians, which will help send those messages along the appropriate nerve fibres to give you relief where you need it.

Are the Needles Sterile?

Yes, every one is individually packed and disposed of in our sharps boxes after a single use. Each needle also comes in its own plastic guide tube so your physiotherapist will not touch the part inserted into your skin.

How Many Sessions Will I Need?

Most conditions are treated with good effect in fewer than 6 appointments, but you might feel better after only one or 2 sessions. It will generally be clear after 2-3 sessions if the acupuncture is of benefit.

I Have (select an option) Epilepsy/a Pacemaker/Man-Flu, Can I Still Have Acupuncture?

Well, unfortunately no is the answer for some conditions like unstable heart conditions or over infected or broken skin, or for women in their first trimester of pregnancy. For people with diabetes, hepatitis, high/low blood pressure or a history of metal allergies, blood disorders or cancer, we’ll help you decide with more in-depth questions whether it’s best to proceed with acupuncture or not. We’ll also work with you to make sure that any treatments given are the current best practice for your specific condition, and in many cases, this doesn’t include acupuncture (man-flu included.)

When Can I BoGet In Touchok?

Any time by sending us an email (, giving us a phone (0141 2372 721) or popping in to see us. We offer a free 15 minute consultation, where you can tell us what ails you and we’ll let you know if physiotherapy would be advised (and if acupuncture is an option, how we suggest proceeding.)

Suffering from Wimbledon elbow?

We’re not talking about a sore elbow caused by switching between the red button too many times trying to keep up with Andy Murray’s progress. Tennis elbow, or to give it its Sunday name, lateral epicondylitis, is a reactive tendon pathology which affects the top of the forearm and the outside of the elbow. Three fancy words to describe a problem with the structure which attaches your muscle to your bone.

You’ll not be surprised to find that the main symptom is pain, often described as “burning”, and there can be stiffness too. Tennis elbow starts with an overload to the tendon, usually through strenuous or repetitive activity (like tennis, funnily enough). Oddly, tennis isn’t the main cause for tennis elbow; we see lots of people with symptoms who work at computers, or work repetitively with tools, or even have poor lifting techniques in the gym.

Men and women are equally affected, and the dominant arm is 3 times more likely to be the sore one. Elbow movements are usually fairly pain free, but resisted wrist extension can be particularly uncomfortable.

Common causes include:

  • gripping or squeezing
  • lifting and carrying (when you’re unused to this activity, e.g. moving house, DIY)
  • using screwdrivers/hammers or painting
  • lifting awkwardly or holdings items and twisting

When the tendon is overloaded, or overused, your body reacts by creating new fibres to replace any damaged ones. The problem occurs when there is an overproliferation of new cells, and the tendon becomes swollen and painful. If the thickened tendon is not treated, it can eventually degenerate. But that’s why we’re here!

Usually symptoms will resolve themselves over a couple of weeks, and you can do lots to help yourself.

Modifying your movements

Instead of gripping and twisting things, try lifting them with your elbow bend and your palm up (not so great with coffee cups, but good for items of clothing, piles of paper etc).


We’re not doctors or pharmacists here, so always ask appropriate advice if you need it. Usually though, your normal painkiller or anti-inflammatory will help your pain, or you could use an anti-inflammatory cream like Voltarol over the muscles at the top of your forearm. You could also use an ice pack to help cool the area, but be careful not to induce ice burns (these are nasty).


Some simple stretches can really relieve the pain of tennis elbow if done several times throughout the day, and held without pain (if it’s burning and aching, ease off the stretch a little). Here is an example of the wrist wrist and elbow being stretched:

Wrist stretch Copyright The Saunders Group Inc PhysioTools

Wrist stretch
Copyright The Saunders Group Inc

Strengthening exercises

Often where there’s pain, there’s a reluctance to use certain muscles and this can lead to weakness. One of the best ways to treat tendinopathies (and tennis elbow is one) is to use eccentric exercise. This is controlled lengthening of a muscle. Using a small weight (a tin of beans is ideal or a small dumbbell is easier to grip), palm facing the floor and elbow resting on a table, slowly lower the weight. Use your other hand to help bend the wrist back up, and start again.

Strengthening Copyright PhysioTools Ltd

Copyright PhysioTools Ltd

If you do find that your arm pain is more severe, disturbing your sleep or interfering with your daily activites, or it has lasted longer than 2 weeks and doesn’t seem to be settling, call us. We can provide lots of different therapies, including exercise and advice on how to avoid future problems. You can usually see a physiotherapist within 48 hours of contacting us by phone (0141 2372 721) or by email (