Elbow pain is not always coming from the elbow. I saw a patient this week with lateral elbow pain lasting 2-3 years. He had seen many practitioners, including 2 Physiotherapists, 2 Registered Massage Therapists and 3 Chiropractors. He had been given a few diagnoses including radial nerve impingement at the elbow and tendonitis or “tennis elbow.” He received lots of manual therapy, and modalities including ultrasound, heat and ice. He has stopped doing anything that aggravates his symptoms. So why have his symptoms not gone away? After a thorough, detailed assessment, I determined that his pain was being referred from his neck. My treatment will involve mobilization, Intramuscular Stimulation (Dry Needling), and progressive exercise training to his neck and arm. I expect symptom improvement after 3-4 sessions, and complete resolution within 6-8 sessions.