Elbow OA and dogs that won't tolerate local needling

Hello,

My query is 2-fold:

1. What do people do when you have a dog with bilateral elbow OA that won't tolerate local needling around the joint? Any particular points you recommend? Or tips to help their tolerance?

2. How do I gain more confidence with local needling? Even in tolerant dogs I am still cautious deviating from the paraspinal muscles (they feel the most "safe").

TIA,

Hattie