Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

Abstract

Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n = 17) group or exercise (n = 19) group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions). Shoulder pain (NPRS) and disability (DASH) were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P < 0.01): individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

Comparison of ultrasound-guided versus blind interventions for supraspinatus tendinopathy: a cadaveric study.

“…With subsequent eccentric work, the tissue is stimulated to give mechanical support to the biological treatment. Arias-Buría et al showed poor results with the use of electrolysis in tendinopathies of the supraspinatus (31).…”

Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application

“…The galvanic current in a saline solution rapidly develops the chemical process of electrolysis, which in turn in-duces tissue ablation 11 . The EPI technique finds indications in the treatment of tendinopathies and fibrosis [12][13][14][15][16] . The rationale for using EPI in the treatment of PH-TrSNE is the ability of the technique to specifically degrade fibrotic adhesions that bind the SN and SM tendon.…”

“…To date however, few studies have tested the effectiveness of the technique. The therapeutic utility of EPI (by some Authors replaced with the acronym PNE, Percutaneous Needle Electrolysis) was tested for the treatment of patellar tendinopathy 12,13 , sub-acromial syndrome 14 , chronic lateral epicondylitis 15 and rectus abdominisrelated groin pain 16 . The clinical results presented in this work are somewhat in conflict, especially given the different methodological choices of the Authors, in particular relative to the intensity and duration of administration of the galvanic current (which varied from 0.3 mA for 1.2 minutes to 3 mA for a few seconds) and suggested physiotherapy administered in combination with the technique.…”

Treatment of proximal hamstring tendinopathyrelated sciatic nerve entrapment: presentation of an ultrasound-guided �Intratissue Percutaneous Electrolysis� application

“…The galvanic current in a saline solution rapidly develops the chemical process of electrolysis, which in turn induces tissue ablation 11 . The EPI technique finds indications in the treatment of tendinopathies and fibrosis [12][13][14][15][16] . The rationale for using EPI in the treatment of PHTrSNE is the ability of the technique to specifically degrade fibrotic adhesions that bind the SN and SM tendon.…”