Conditions · Carrollwood · Tampa Bay
Tennis Elbow Treatment in Tampa
Elbow pain rarely comes from tennis. Most tennis elbow has nothing to do with a racket.
Lateral elbow pain shows up with a jar lid, a coffee cup, a car door, a handshake. Dr. Bobby Koser, DC, chiropractic physician, examines the elbow and forearm, then treats with hands-on work, dry needling, or both. He is certified in dry needling by the Florida Department of Health. New here? Start with the Pain Source Exam.
Tennis Elbow Overview
Most elbow pain follows a few patterns
Elbow pain sounds vague until you examine it. Most of it fits one of a few patterns. The most common is tennis elbow: a tendon worn down by more load than it was ready for, which doctors call tendinopathy, at the point where the forearm muscles attach on the outside of the elbow. Golfer's elbow is the same kind of problem on the inner side, where the muscles that curl the wrist attach. And some elbow pain doesn't start in a tendon at all. The joint or a nerve can be the source, and the exam is how we tell the difference.
What tennis elbow feels like
Tennis elbow is pain and tenderness over the bony bump on the outside of the elbow, where the forearm muscles that lift the wrist and fingers attach. It gets worse with gripping: opening a jar, carrying a grocery bag, lifting a coffee cup, turning a doorknob or a key. A handshake can be enough to make you wince. Some people also notice a dull ache running down the forearm, or a weaker grip than they're used to.
You don’t have to play tennis to get tennis elbow
The name is misleading, because most of the people we see with it never picked up a racket. It comes from repeated gripping and wrist extension: a computer mouse, a screwdriver, painting, gardening, cooking, carrying a toddler on one hip. Anyone whose forearm does the same motion over and over, day after day, is a candidate.
The mechanism is the same either way. That's why the exam and the treatment don't change based on whether you play the sport.
How we treat it
What you're offered depends on what the exam finds. This is the range of what's available here, not a fixed plan for every case.
- Hands-on soft-tissue work over the forearm extensor muscles, where the repeated gripping load actually lands.
- Dry needling for trigger points and myofascial pain in the forearm muscles, by feel.
- Ultrasound-guided dry needling when the muscle we're targeting sits deeper. We watch the needle reach the spot on the screen, and so do you.
- Activity and load changes: grip technique, tool or equipment changes, workstation setup, and what to scale back for now.
- Bracing or taping as an add-on, to reduce load on the tendon attachment during activity while the rest of the plan does its work.
We'll tell you which of these fits your case, and why, before we begin.
How long it actually takes
Tennis elbow is a worn tendon, and tendons are slow tissue. It didn't show up overnight, and it doesn't settle in a week or two, even with treatment. Plan in months, not weeks. Full grip strength can take longer than that to return.
What the Research Shows
Cited in full, so you can check it yourself.
On dry needling. A 2024 meta-analysis pooled 17 clinical trials with 979 patients and found that dry needling improved pain, arm function, and grip strength in people with tennis elbow.1 The pain finding was clearest in the first week after treatment. Grip strength is worth pausing on, because it is the thing tennis elbow actually takes from most people: the coffee cup and the handshake. Function and strength are also the slower gains, which is why the timeline above reads the way it does.
On acupuncture. A systematic review in the journal Rheumatology found evidence that acupuncture can relieve tennis elbow pain in the short term.2 Longer-term benefit has not been established, and a later review could not draw firm conclusions about arm function or strength, so we offer it for what the research supports and not more. Acupuncture here is its own visit, on a different framework from dry needling. Dr. Koser is certified in acupuncture by the Florida Board of Chiropractic Medicine.
These are the reason these treatments are offered here.
1. Ma X, Qiao Y, Wang J, Xu A, Rong J. Therapeutic effects of dry needling on lateral epicondylitis: an updated systematic review and meta-analysis. Arch Phys Med Rehabil. 2024;105(11):2184–2197. PubMed
2. Trinh KV, Phillips SD, Ho E, Damsma K. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology (Oxford). 2004;43(9):1085–1090. PubMed
What it costs to start
$195Regular price $330
Self-pay only, one per patient.
Pain has a source. This visit looks for where it is coming from.
- A complete examination with Dr. Koser, which may include a live ultrasound look at the muscles and soft tissue where it hurts.
- Treatment the same visit unless the examination finds a reason it should not: a chiropractic adjustment, dry needling, cupping, laser, or electrical stimulation with infrared, chosen from what the examination finds and what is safe for you.
- Your findings explained the same day.
You’ll leave knowing what we found and what it means. First visit with us, one per patient.
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Self-pay patients only. Not valid with insurance, PIP/auto claims, Medicare, or Medicaid. Injured in a car accident? Book the Auto Accident Injury Visit instead.
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Common questions about tennis elbow
What does tennis elbow feel like?
Pain and tenderness over the bony bump on the outside of the elbow, worse with gripping. Opening a jar, lifting a coffee cup, turning a doorknob, or a firm handshake can bring it on. Some people also notice forearm ache or a weaker grip.
Do I have to play tennis to get tennis elbow?
No. Most of the people we see with it never picked up a racket. It comes from repeated gripping and wrist extension: a mouse, a tool, painting, gardening, cooking, or carrying a child. Anyone whose forearm repeats the same motion regularly is a candidate.
How long does tennis elbow take to settle down?
Longer than most people expect. It's slow tissue, and recovery is measured in months rather than weeks. Full grip strength can take longer to return.
Do I need an MRI?
Usually not to start, because most cases of tennis elbow are assessed through your history and a physical exam in the office, not imaging. If your case doesn't fit the typical pattern, or a reasonable trial of care doesn't help, we can refer you out for imaging or a specialist opinion.
What's the difference between dry needling and ultrasound-guided dry needling for my elbow?
Both treat trigger points and myofascial pain in the forearm muscles. Most areas are treated by feel. When the muscle we're targeting sits deeper, or we want to confirm the spot visually as we treat, we use ultrasound guidance instead. We'll tell you which fits your case before we begin.
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This page is general health information and is not medical advice for any individual. The studies summarized describe groups, not any one person’s outcome, and whether a finding explains your symptoms can only be determined by examination. Talk to Dr. Bobby Koser, DC, about your own situation.
Find the source. Treat it with precision.
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