Effectiveness of Ultrasound-Guided Percutaneous Electrolysis for Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Abstract

Objective To evaluate the effects of ultrasound-guided percutaneous electrolysis alone or as an adjunct to other interventions on pain and pain-related disability for musculoskeletal pain conditions. Databases and Data Treatment Search of MEDLINE database, Allied and Complementary Medicine Database, EMBASE database, Cumulative Index to Nursing & Allied Health Literature database, EBSCO database, PubMed database, Physiotherapy Evidence Database, Cochrane Library database, Scopus database, and Web of Science database. Randomized controlled trials in which at least one group received ultrasound-guided percutaneous electrolysis for treatment of musculoskeletal pain. To be eligible, studies had to include humans and collect outcomes on pain intensity and pain-related disability for musculoskeletal pain syndromes. Data were extracted by two reviewers. The risk of bias was assessed by the Cochrane Guidelines and the quality of evidence was reported using the Grading of Recommendations Assessment, Development and Evaluation approach. Standardized mean differences (SMDs) and random effects were calculated. Results Ten studies were included. The meta-analysis found that ultrasound-guided percutaneous electrolysis reduced the mean pain intensity by –2.06 (95% confidence interval [CI], –2.69 to –1.42) and the pain intensity as assessed with a visual analog scale or a numeric pain rating scale with a large size effect (SMD = –1.15; 95% CI, –1.48 to –0.81) and also improved pain-related disability with a large size effect (SMD = 0.95; 95% CI, 0.73–1.18) as compared with comparison groups. No differences in effect sizes were found among the short-term, midterm, and long-term follow-ups. The risk of bias was generally low, but the heterogeneity of the overall result downgraded the evidence level. Trials included heterogeneous musculoskeletal pain conditions and short-term, midterm, and long-term follow-ups. Conclusion Moderate evidence suggests positive effects of ultrasound-guided percutaneous electrolysis for pain and pain-related disability in musculoskeletal pain conditions relative to a comparison group in the short term, midterm, and long term.

A new ultrasound-guided percutaneous electrolysis and exercise treatment in patellar tendinopathy: three case reports

“…One of the hypotheses currently handled in publications [22] investigating evident clinical effects of electrolysis, is the clearing of algogenic and inflammatory substances that have been found in degeneration tendon areas and its periphery at initial stages of tendon degeneration. In a recent systematic review, Gomez-Chiguano et al [23] presented results of moderate scientific evidence of electrolysis for the treatment of pain and musculoskeletal dysfunction. For this reason, the aim of our study was to determine the effects of a new treatment with percutaneous electrolysis directed to peripheral tendon, with or without the presence of degenerative zone.…”

Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome

“…One needling intervention that is commonly US-guided is percutaneous electrolysis, an intervention consisting of the application of a galvanic electrical current throughout a filament needle. A recent meta-analysis found moderate evidence suggesting a positive effect of US-guided percutaneous electrolysis for pain and related disability in patients with musculoskeletal pain [ 13 ]. Further, an animal study has observed that the application of percutaneous electrolysis can release nerve tissue, i.e., the sciatic nerve, from a fibrous entrapment [ 14 ].…”

Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial

“…Although scientific evidence concerning PE is still limited compared to other physical therapies, the number of publications investigating the effectiveness of this treatment is progressively growing [ 6 , 7 ]. The efficacy of this technique has been mainly studied in musculoskeletal disorders; in fact, a recent meta-analysis has found moderate evidence suggesting a positive effect of PE for reducing pain and related disability in these pathologies [ 8 ]. Some of the conditions that could benefit from PE treatment are patellar tendinopathy, lateral epicondylalgia, shoulder pain, whiplash syndrome, or temporomandibular pain [ 4 , 6 , 9 , 10 , 11 , 12 , 13 ].…”

“…Some of the conditions that could benefit from PE treatment are patellar tendinopathy, lateral epicondylalgia, shoulder pain, whiplash syndrome, or temporomandibular pain [ 4 , 6 , 9 , 10 , 11 , 12 , 13 ]. However, which musculoskeletal pain conditions would receive the greatest benefit from this approach and the ideal dosage are questions still unanswered [ 8 ].…”