The Possibilities of Applying Ultrasound-Guided Percutaneous Electrolysis For Musculoskeletal Pain
Keywords:
physical therapy, percutaneous electrolysis, ultrasound visualization, rehabilitation, pain treatment
Abstract
Physical therapy is constantly evolving and adapting to new information and technologies in order to provide optimal care to patients with various musculoskeletal conditions. In this context, recent advances in technology and therapy methods has led to the introduction of new techniques, among which ultrasound-guided percutaneous electrolysis stands out. This technique, which combines the principle of electrotherapy (direct current) with percutaneous needle application, is becoming increasingly significant in the rehabilitation of patients with tendinopathies, myofascial pain syndromes, and other musculoskeletal conditions. The largest number of studies to date indicate its effectiveness, whether it is applied as an individual procedure, or in combination with other physical modalities and therapeutic exercises. The therapeutic effects were monitored in both the short and long term. The most adequate therapeutic protocols are still being sought after, considering that this technique has recently been introduced as a way of decreasing the symptoms and consequences of musculoskeletal pain. The aim of this research was to review the approaches and therapeutic protocols for the application of percutaneous electrolysis in the treatment of musculoskeletal pain. The research results indicate positive therapeutic effects, as well as the advantages of applying ultrasound-guided percutaneous electrolysis for musculoskeletal pain.
References
1. El-Tallawy SN, Nalamasu R, Salem GI, et al. Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain. Pain Ther 2021; 10(1): 181-209.
2. Williams A, Kamper SJ, Wiggers JH, et al. Musculoskeletal conditions may increase the risk of chronic disease: A systematic review and metaanalysis of cohort studies. BMC Med 2018; 16(1): 1-9.
3. Musculoskeletal health: Geneva: Word Health Organization, 2022. (https://www.who.int/news-room/fact-sheets/ detail/musculoskeletal-conditions).
4. GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5(9): 508-22.
5. Babatunde OO, Jordan JL, Van der Windt DA, et al. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS one 2017; 12(6): e0178621.
6. Mannerkorpi K, Henriksson C. Non-pharmacological treatment of chronic widespread musculoskeletal pain. Best Pract Res Clin Rheumatol 2007; 21(3): 513-34.
7. Valera-Garrido F, Minaya-Muñoz F. Fundamentos y principios de la electrolisis percutánea musculoesquelética. In Fisioterapia Invasiva. 2nd ed. Barcelona: Elsevier, 2016: 390-91.
8. Stević R, Mašulović D. Ultrazvuk u dijagnostici povreda mišića i tetiva. Srpski arhiv za celokupno lekarstvo 2009; 137(11-12): 647-52.
9. Robotti G, Draghi F, Bortolotto C, et al. Ultrasound of sports injuries of the musculoskeletal system: gender differences. J Ultrasound 2020; 23(3): 279-85.
10. Pirri C, Pirri N, Stecco C, et al. 'Ultrasound Examination' of the Musculoskeletal System: Bibliometric/Visualized Analyses on the Terminology (Change). Tomography 2023; 9(1): 352-61.
11. Sánchez Ibañez JM. Clinical Course in the Treatment of Chronic Patellar Tendinopathy through Ultrasound Guided Percutaneous Electrolysis Intratissue (EPI®): Study of a Population Series of Cases in Sport. Ph.D. Thesis, USA: Atlantic International University, Honolulu, 2009.
12. Colmena, C. New Technique in Tendon Sport Recovery. Percutaneous Electrolysis Intratissue (EPI®). Int J Phys Med R habil 2013; 1: 1000113.
13. Borrella-Andrés S, Malo-Urriés M, Pérez-Bellmunt A, et al. Application of Percutaneous Needle Electrolysis Does Not Elicit Temperature Changes: An In Vitro Cadaveric Study. Int J Environ Res Public Health 2023; 19(23): 15738.
14. Gómez-Chiguano GF, Navarro-Santana MJ, Cleland JA, et al. Effectiveness of Ultrasound-Guided Percutaneous Electrolysis for Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Pain Med 2021; 22: 1055-71.
15. Rodríguez-Huguet M, Góngora-Rodríguez J, Rodríguez-Huguet P, et al. Effectiveness of percutaneous electrolysis in supraspinatus tendinopathy: A single-blinded randomized controlled trial. J Clin Med 2020; 6: 1837.
16. García Naranjo J, Barroso Rosa S, Loro Ferrer JF, et al. A Novel Approach in the Treatment of Acute Whiplash Syndrome: Ultrasound-Guided Needle Percutaneous Electrolysis. A Randomized Controlled Trial. Orthop Traumatol Surg Res 2017; 103:1229-234.
17. Margalef R, Valera-Garrido F, Minaya-Muñoz F, et al. Percutaneous Needle Electrolysis Reverses Neurographic Signs of Nerve Entrapment by Induced Fibrosis in Mice. Evid Based Complement Altern Med 2020; 2020: 6615563.
18. Millar NL, Silbernagel KG, Thorborg K, et al. Tendinopathy [published correction appears in Nat Rev Dis Primers. 2021 Feb 3;7(1):10]. Nat Rev Dis Primers 2021; 7(1):1.
19. Abat F, Sánchez-Sánchez JL, Martín-Nogueras AM, et al. Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique (USGET) versus conventional electro-physiotherapeutic treatment on patellar tendinopathy. J Exp Orthop 2016; 3(1): 34.
20. Valera-Garrido F, Minaya-Muñoz F, Medina-Mirapeix F. Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: short-term and long-term results. Acupunct Med 2014; 32(6): 446-54.
21. Arias-Buría JL, Truyols-Domínguez S, Valero-Alcaide R, et al. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial. Evid Based Complement Alternat Med 2015; 2015: 315219.
22. Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 2015; 23(4): 1046-52.
23. de Miguel Valtierra L, Salom Moreno J, Fernández-de-Las-Peñas C, et al. Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial. J Pain 2018; 19(10):1201-10.
24. Lopez-Martos R, Gonzalez-Perez LM, Ruiz-Canela-Mendez P, et al. Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. Med Oral Patol Oral Cir Bucal 2018; 23(4): e454-e462.
25. Valera-Garrido F, Jiménez-Rubio S, Minaya-Muñoz F, et al. Ultrasound-Guided Percutaneous Needle Electrolysis and Rehab and Reconditioning Program for Rectus Femoris Muscle Injuries: A Cohort Study with Professional Soccer Players and a 20-Week Follow-Up. Appl Sci 2020; 10(21): 7912.
26. De-la-Cruz-Torres B, Barrera-García-Martín I, Valera-Garrido F, et al. Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial. Evid Based Complement Alternat Med 2020; 2020: 4156258.
27. Rodríguez-Huguet M, Góngora-Rodríguez J, Lomas-Vega R, et al. Percutaneous Electrolysis in the Treatment of Lateral Epicondylalgia: A Single-Blind Randomized Controlled Trial. J Clin Med 2020; 9(7): 2068.
28. López-Royo MP, Ríos-Díaz J, Galán-Díaz RM, et al. A Comparative Study of Treatment Interventions for Patellar Tendinopathy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102(5): 967-75.
29. Benito-de-Pedro AI, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al. Efficacy of Deep Dry Needling versus Percutaneous Electrolysis in Ultrasound-Guided Treatment of Active Myofascial Trigger Points of the Levator Scapulae in Short-Term: A Randomized Controlled Trial. Life (Basel) 2023; 13(4): 939.
2. Williams A, Kamper SJ, Wiggers JH, et al. Musculoskeletal conditions may increase the risk of chronic disease: A systematic review and metaanalysis of cohort studies. BMC Med 2018; 16(1): 1-9.
3. Musculoskeletal health: Geneva: Word Health Organization, 2022. (https://www.who.int/news-room/fact-sheets/ detail/musculoskeletal-conditions).
4. GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5(9): 508-22.
5. Babatunde OO, Jordan JL, Van der Windt DA, et al. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS one 2017; 12(6): e0178621.
6. Mannerkorpi K, Henriksson C. Non-pharmacological treatment of chronic widespread musculoskeletal pain. Best Pract Res Clin Rheumatol 2007; 21(3): 513-34.
7. Valera-Garrido F, Minaya-Muñoz F. Fundamentos y principios de la electrolisis percutánea musculoesquelética. In Fisioterapia Invasiva. 2nd ed. Barcelona: Elsevier, 2016: 390-91.
8. Stević R, Mašulović D. Ultrazvuk u dijagnostici povreda mišića i tetiva. Srpski arhiv za celokupno lekarstvo 2009; 137(11-12): 647-52.
9. Robotti G, Draghi F, Bortolotto C, et al. Ultrasound of sports injuries of the musculoskeletal system: gender differences. J Ultrasound 2020; 23(3): 279-85.
10. Pirri C, Pirri N, Stecco C, et al. 'Ultrasound Examination' of the Musculoskeletal System: Bibliometric/Visualized Analyses on the Terminology (Change). Tomography 2023; 9(1): 352-61.
11. Sánchez Ibañez JM. Clinical Course in the Treatment of Chronic Patellar Tendinopathy through Ultrasound Guided Percutaneous Electrolysis Intratissue (EPI®): Study of a Population Series of Cases in Sport. Ph.D. Thesis, USA: Atlantic International University, Honolulu, 2009.
12. Colmena, C. New Technique in Tendon Sport Recovery. Percutaneous Electrolysis Intratissue (EPI®). Int J Phys Med R habil 2013; 1: 1000113.
13. Borrella-Andrés S, Malo-Urriés M, Pérez-Bellmunt A, et al. Application of Percutaneous Needle Electrolysis Does Not Elicit Temperature Changes: An In Vitro Cadaveric Study. Int J Environ Res Public Health 2023; 19(23): 15738.
14. Gómez-Chiguano GF, Navarro-Santana MJ, Cleland JA, et al. Effectiveness of Ultrasound-Guided Percutaneous Electrolysis for Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Pain Med 2021; 22: 1055-71.
15. Rodríguez-Huguet M, Góngora-Rodríguez J, Rodríguez-Huguet P, et al. Effectiveness of percutaneous electrolysis in supraspinatus tendinopathy: A single-blinded randomized controlled trial. J Clin Med 2020; 6: 1837.
16. García Naranjo J, Barroso Rosa S, Loro Ferrer JF, et al. A Novel Approach in the Treatment of Acute Whiplash Syndrome: Ultrasound-Guided Needle Percutaneous Electrolysis. A Randomized Controlled Trial. Orthop Traumatol Surg Res 2017; 103:1229-234.
17. Margalef R, Valera-Garrido F, Minaya-Muñoz F, et al. Percutaneous Needle Electrolysis Reverses Neurographic Signs of Nerve Entrapment by Induced Fibrosis in Mice. Evid Based Complement Altern Med 2020; 2020: 6615563.
18. Millar NL, Silbernagel KG, Thorborg K, et al. Tendinopathy [published correction appears in Nat Rev Dis Primers. 2021 Feb 3;7(1):10]. Nat Rev Dis Primers 2021; 7(1):1.
19. Abat F, Sánchez-Sánchez JL, Martín-Nogueras AM, et al. Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique (USGET) versus conventional electro-physiotherapeutic treatment on patellar tendinopathy. J Exp Orthop 2016; 3(1): 34.
20. Valera-Garrido F, Minaya-Muñoz F, Medina-Mirapeix F. Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: short-term and long-term results. Acupunct Med 2014; 32(6): 446-54.
21. Arias-Buría JL, Truyols-Domínguez S, Valero-Alcaide R, et al. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial. Evid Based Complement Alternat Med 2015; 2015: 315219.
22. Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 2015; 23(4): 1046-52.
23. de Miguel Valtierra L, Salom Moreno J, Fernández-de-Las-Peñas C, et al. Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial. J Pain 2018; 19(10):1201-10.
24. Lopez-Martos R, Gonzalez-Perez LM, Ruiz-Canela-Mendez P, et al. Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. Med Oral Patol Oral Cir Bucal 2018; 23(4): e454-e462.
25. Valera-Garrido F, Jiménez-Rubio S, Minaya-Muñoz F, et al. Ultrasound-Guided Percutaneous Needle Electrolysis and Rehab and Reconditioning Program for Rectus Femoris Muscle Injuries: A Cohort Study with Professional Soccer Players and a 20-Week Follow-Up. Appl Sci 2020; 10(21): 7912.
26. De-la-Cruz-Torres B, Barrera-García-Martín I, Valera-Garrido F, et al. Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial. Evid Based Complement Alternat Med 2020; 2020: 4156258.
27. Rodríguez-Huguet M, Góngora-Rodríguez J, Lomas-Vega R, et al. Percutaneous Electrolysis in the Treatment of Lateral Epicondylalgia: A Single-Blind Randomized Controlled Trial. J Clin Med 2020; 9(7): 2068.
28. López-Royo MP, Ríos-Díaz J, Galán-Díaz RM, et al. A Comparative Study of Treatment Interventions for Patellar Tendinopathy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102(5): 967-75.
29. Benito-de-Pedro AI, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al. Efficacy of Deep Dry Needling versus Percutaneous Electrolysis in Ultrasound-Guided Treatment of Active Myofascial Trigger Points of the Levator Scapulae in Short-Term: A Randomized Controlled Trial. Life (Basel) 2023; 13(4): 939.