Percutaneous electrolysis and microelectrolysis for musculoskeletal pain management: milliamps or microamps? An evidence-based comparison through systematic review and meta-analysis

Hernán Andrés de la Barra Ortiz; Claudio Chamorro; Óscar Ronzio

doi:10.5114/areh.2024.141103

Figures & Tables

RoB Graph: Authors’ assessments of each risk-of-bias item, presented as percentages across all included studies

Forest plots for pain intensity at rest at the end of treatment for both electrolysis modalities

Forest plots for secondary outcomes for both electrolysis modalities: pain pressure threshold (4a), disability (4b), and function (4c)

Summary of findings and quality of evidence (GRADE) for interesting outcomes

Certainty assessment							№ of patients		Effect	Certainty	Importance^f
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	electrolysis or microelectrolysis	other physical therapy interventions	Absolute
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	electrolysis or microelectrolysis	other physical therapy interventions	(95% CI)
Pain intensity for microelectrolysis (assessed with: VAS, NPRS, VISA-A, VISA-P and VRS)
11	randomised trials	serious^a	serious^b	not serious^c	not serious^d	none	276	262	SMD −0.92 fewer (−1.30 to −0.50)	⊕⊕◯◯ Low	CRITICAL
Pain intensity for electrolysis (assessed with: VAS, NPRS, VISA-A, VISA-P and VRS)
14	randomised trials	serious^a	serious^b	not serious^c	not serious^d	none	449	457	SMD −0.30 fewer (−0.59 to −0.01)	⊕⊕◯◯ Low	IMPORTANT
Disability for microelectrolysis (assessed with: DASH and SPADI)
3	randomised trials	serious^a	not serious^b	not serious^c	serious^d	none	95	95	SMD −0.92 fewer (−1.30 to 0.54)	⊕⊕◯◯ Low	IMPORTANT
Disability for electrolysis (assessed with: DASH, NPQ, SPADI, limited ROM)
5	randomised trials	serious^a	very serious^b	not serious^c	serious^d	none	173	135	SMD 1.84 fewer (3.11 to 0.56)	⊕ ◯◯◯ Very low	IMPORTANT
Function for microelectrolysis (assessed with: VISA-A and FAAM)
2	randomised trials	serious^a	very serious^b	not serious^c	serious^d	publication bias strongly suspected^e	48	39	SMD 2.38 more (0.88 to 3.89)	⊕ ◯◯◯ Very low	IMPORTANT

Electrolysis and microelectrolysis parameters

N°	Electrolysis parameters	Technique	Musculoskeletal disorder	Ecoguided	Intensitity	Time application (sec)	Needle	Series	Dose
1	Da Silva et al. (2014) [7]	MEP®***	Calcaneal tendinopathy	No	450 μA (0.45 mA)	20 sec	0.22 × 13mm	3 × 3 points	27 mC
2	Abat et al. (2014) [8]	EPI®*	Patellar tendinopathy	Yes	3 mA	NS	NS	3	NS
3	Arias-Buría et al. (2015) [9]	EPTE®**	SAIS	Yes	350 μA (0.35 mA)	80 sec	0.3 × 25 mm	NS	28 mC
4	Ronzio et al. (2015) [10]	MEP®***	MFPS - MTrPs	No	500 μA (0.5 mA)	180 sec	0.3 × 25 mm	1	90 mC
5	Abat et al. (2016) [11]	EPI®*	Patellar tendinopathy	Yes	2 mA	NS	0.25 × 25 mm	3	NS
6	Kazemi et al. (2015) [22]	EPI®*	SAIS	Yes	6 mA	4 sec	NS	3	72 mC
7	Moreno et al. (2016) [23]	EPI®*	Pubalgia	Yes	3 mA	5 sec	0.33 × 50 mm	3	45 mC
8	García Naranjo et al. (2016) [24]	EPI®*	Whiplash	Yes	4 mA	NS	0.16 × 25 mm	3	NS
9	Moreno et al. (2017) [25]	EPI®*	Adductor longus enthesopathy	Yes	3 mA	5 sec	0.33 × 50 mm	3 bilaterally	45 mC
10	Ronzio et al. (2017) [26]	MEP®***	Calcaneal tendinopathy	No	450 μA (0.45 mA)	20 sec	0.22 × 13 mm	3	27 mC
11	Lopez-Martos et al. (2018) [27]	EPI®*	MFPS - MTrPs	No	2 mA	3 sec	0.25 × 40 mm	3	18 mC
12	Fernández-Rodríguez et al. (2018) [28]	EPTE®**	Heel pain	Yes	NS	NS	0.35 × 40 mm	NS	28 mC
13	Iborra-Marcos et al. (2018) [29]	EPI®*	Plantar fasciitis	Yes	3 mA	5 sec	0.30 × 25 mm	3	45 mC
14	de Miguel Valtierra et al. (2018) [30]	EPTE®**	SAIS	Yes	350 μA (0.35 mA)	90 sec	0.30 × 25 mm	1	31.5 mC
15	Ortiz et al. (2020) [31]	MEP®***	MFPS - MTrPs	No	600 μA (0.6 mA)	180 sec	0.30 × 25 mm	3	10.8
16	Rodríguez-Huguet et al. (2020) [32]	EPTE®**	SAIS	Yes	350 μA (0.35 mA)	80 sec	0.30 × 25 mm	1	28 mC
17	Rodríguez-Huguet et al. (2020) [33]	EPTE®**	Epicondylalgia	Yes	350 μA (0.35 mA)	80 sec	0.30 × 25 mm	1	28 mC
18	Al-Boloushi et al. (2020) [34]	EPI®*	Heel pain	Yes	1.5 mA	5 sec	0.30 × 25 mm	5	37.5 mC
19	Calderón-Díez et al. (2020) [35]	EPI®*	Calcaneal tendinopathy	Yes	3 mA	10 sec	0.30 × 25 mm	1	30 mC
20	de-la-Cruz-Torres et al. (2020) [36]	EPI®*	Chronic soleus injury	Yes	2.5 mA	3 sec	0.30 × 40mm	3	22.5 mC
21	Valera-Calero et al. (2021) [37]	EPTE®**	Patellofemoral pain	No	EG 1: 660 μA (0.66 mA) EG 2: 220 μA (0.22 mA)	EG 1: 10 sec EG 2: 30 sec	0.30 × 40 mm	1	6.6 mC
22	Lopez-Royo et. al (2021) [38]	EPI®*	Patellar tendinopathy	Yes	3 mA	3 sec	0.25 × 25 mm	3	27 mC
23	Fernandez-Sanchis et al. (2022) [39]	EPI®*	Patellar tendinopathy	Yes	3 mA	3 sec	0.25 × 25 mm	3	27 mC
24	Benito-de-Pedro et al. (2023) [40]	EPI®*	MFPS - MTrPs	Yes	1.5 mA	5 sec	0.30 × 30 mm or 0.30 × 40 mm	3 to 5	22.5 to 37.5 mC
25	De-la-Cruz-Torres et al. (2023) [41]	EPI®*	Chronic soleus injury	Yes	1.5 mA	3 sec	0.30 × 40 mm	3	13.5 mC
26	Góngora-Rodríguez et al. (2024) [42]	EPTE®**	SAIS	Yes	350 μA (0.35 mA)	72 sec	0.30 × 40 mm	1	25.2 mC
27	Di Gesù et al. (2024) [43]	EPI®*	Calcaneal tendinopathy	Yes	2 mA	10 sec	0.25 × 25 mm	2	40 mC
28	Rodríguez-Huguet (2024) [44]	EPTE®**	Epicondylalgia	Yes	350 μA (0.35 mA)	80 sec	0.30 × 25 mm	1	28 mC

Characteristics of the studies included in the present meta-analysis

N°	Author (year) Country	Musculoskeletal disorder	PEDro score	Location of research implementation	Sample Groups (n) Mean age (SD)	Electrolysis Technique	Interventions	Sessions	Outcomes	Assessment	Results after treatment	Sources of funding
1	Da Silva et al. (2014) [7] Brazil	Calcaneal tendinopathy	7/10⁺	Physiotherapy Department of Integrated Clinics of the Centro Universitário do Rio Grande do Norte (UNI-RN)	n = 20 EG = 10 (♂ NS; ♀ NS) CG = 10 (♂ NS; ♀ NS) 45 (NS)	Microelectrolysis (MEP®)	EG: MEP + TE + DTM CG: TE + DTM	4s (1s per week) (4 weeks)	(A) PI (VISA-A)	T0: baseline T1: post-treatment	EG: ↓PI* CG: ↓PI* EG < CG: ↓PI	Not reported
2	Abat et al. (2014) [8] Spain	Patellar tendinopathy	4/10⁺	Department of Orthopedic Surgery, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona ICATME-Hospital Universitari Quirón Dexeus, Autonomous University of Barcelona	n = 40 EG1 = 21 (♂ = 17; ♀ = 4) EG2 = 19 (♂ = 18; ♀ = 1) 26 (± 8.3) Participants were divided according to the Blazina score	Electrolysis (EPI®)	EG1: TE + EPI EG2: TE + EPI No CG	10s (2 weeks)	(A) PI (VISA-P) (B) Function (VISA-P) (C) Function (TLS)	T0: baseline T1: 3-month follow-up T2: 2-year follow-up T3: 5-year follow-up T4: 10-year follow-up	EG1: ↓PI* and ↑function* EG2: ↓PI* and ↑function*	Not reported
3	Arias-Buría et al. (2015) [9] Spain	SAIS	7/10**	Physical therapy clinic in Madrid	n = 36 EG = 17 (♂ = 4;♀ = 13) CG = 19 (♂ = 5; ♀ = 14) 57 (± 6.5)	Microelectrolysis (EPTE®	EG: EPTE + TE CG: TE	4s (1s per week) (4 weeks)	(A) PI (NPRS) (B) Disability (DASH)	T0: baseline T1: during treatment (session 2) T2: post-treatment	EG: ↓PI* and ↓disability* CG: ↓PI* and ↓disability* EG < CG: ↓PI* and ↓disability*	Not funded
4	Ronzio et al. (2015) [10] Argentina	MFPS - MTrPs	4/10⁺	Department of Physiotherapy, Maimónides University, Buenos Aires	n = 16 EG = 8 (♂ NS; ♀ NS) CG = 8 (♂ NS; ♀ NS) 24 (NS)	Microelectrolysis (MEP®)	EG: MEP CG: Placebo	1s	(A) PPT (ALG)	T0: baseline T1: post-treatment (1 min) T2: post-treatment (10 min)	EG: ↑PPT* CG: ↑PPT EG > CG: ↑PPT*	Not reported
5	Abat et al. (2016) [11] Spain	Patellar tendinopathy	7/10**	Outpatient clinics in the city of Barcelona	n = 64 EG = 32 (♂ = 24; ♀ = 8) CG = 32 (♂ = 27; ♀ = 5) 39 (± 6.2) Participants of each group were divided according to the VISA-P score (< o > 90 points)	Electrolysis (EPI®)	EG: EPI + TE CG: US + LLLT + ITFC + TE	4s (8 weeks)	(A) Function (VISA-P)	T0: baseline T1: post-treatment	EG: ↑function* CG: ↑function* EG > CG: ↑function*	Not funded
6	Kazemi et al. (2015) [22] Spain	SAIS	5/10⁺	Institute of Physiotherapy and Sports, University of Alcalá, Madrid	n = 40 EG 1 = 10 (♂ NS; ♀ NS) EG 2 = 10 (♂ NS; ♀ NS) EG 3 = 10 (♂ NS; ♀ NS) CG = 10 (♂ NS; ♀ NS) 39.9 (± 3.9)	Electrolysis (EPI®)	EG 1 = EPI (MTsPs) EG 2 = EPI (Infraspinatus tendon) EG 3 = EPI (MTrPs and infraspinatus tendon) CG: No treatment	2s (2 weeks)	(A) PI (VAS) (B) Limited ROM (GNM)	T0: baseline T1: during treatment (1 week) T2: during treatment (2 weeks) T3: post-treatment	EG 1: ↓PI* and ↓ limited ROM* EG 2: ↓PI* and ↓ limited ROM* EG 3: ↓PI* and ↓ limited ROM* CG: ↓PI and ↓ limited ROM EG3 < EG2 = EG1 < CG: ↓PI* and ↓ limited ROM*	Not reported
7	Moreno et al. (2016) [23] Italy	Pubalgia	4/10⁺	Udinese Football Club	n = 8 EG = 8 (♂ = 8; ♀ = 0) 27 (± 4.4)	Electrolysis (EPI®)	EG: EPI CG: No CG	4–6s (4 weeks)	(A) PI (VRS) (B) Function (PSFS)	T0: baseline T1: during treatment (24 hours) T2: during treatment (1 week) T3: post-treatment T4: 6-month follow-up	EG: ↓PI* and ↑function*	Not reported
8	García Naranjo et al. (2016) [24] Spain	Whiplash	5/10⁺	Vecindario Rehabilitation Centre, Santa Lucía, Gran Canaria Island	n = 100 EG = 50 (♂ = 16; ♀ = 34) CG = 50 (♂ = 20; ♀ = 30) 38 (± 8.7)	Electrolysis (EPI®)	EG: EPI CG: MWT + TENS + US + massage + TE	3s (1s per week) (3 weeks)	(A) PI (VAS) (B) PPT (ALG) (C) Disability (NPQ)	T0: baseline T1: post-treatment	EG: ↓PI, ↓disability and ↑PPT* CG: ↓PI, ↓disability and ↑PPT* EG < CG: ↓PI* and ↓disability* EG > CG: ↑PPT*	Not funded
9	Moreno et al. (2017) [25] Italy	Adductor longus enthesopathy	9/10⁺	Udinese Football Club	n = 24 EG = 8 (♂ = 11; ♀ = 0) CG = 8 (♂ = 13; ♀ = 0) 26 (± 4.7)	Electrolysis (EPI®)	EG: EPI + TE CG: TE	2s (1 week)	(A) PI (NPRS) (B) Function (PSFS)	T0: baseline T1: post-treatment T2: 2-month follow-up T3: 4-month follow-up T4: 6-month follow-up	EG: ↓PI* and↑function* CG: ↓PI* and ↑function* EG < CG: ↓PI* EG > CG: ↑function	Not funded
10	Ronzio et al. (2017) [26] Argentina	Calcaneal tendinopathy	6/10⁺	Integrated Clinics of Potiguar University, Rio Grande, Natal	n = 20 EG = 10 (♂ NS; ♀ NS) CG = 10 (♂ NS; ♀ NS) 24 (NS)	Microelectrolysis (MEP®)	EG: MEP + TE + DTM CG: TE + DTM	4s (1s per week) (4 weeks)	(A) PI (VAS) (B) ROM (GNM) (C) Function (VISA-A)	T0: baseline T1: during treatment (1 week) T2: during treatment (2 week) T3: during treatment (3 week) T4: post-treatment	EG: ↓PI, ↑ROM and↑function* CG: ↓PI, ↑ROM and↑function* EG < CG: ↓PI* EG > CG: ↑ROM* and↑function*	This work has been supported by Universidade Potiguar (Brazil)
11	Lopez-Martos et al. (2018) [27] Spain	MFPS - MTrPs	6/10**	Department of Oral and Maxillofacial Surgery, Virgen del Rocío University Hospital, Seville	n = 60 EG = 20 (♂ = 5; ♀ = 15) CG1 = 20 (♂ = 2; ♀ = 18) CG2 = 20 (♂ = 1; ♀ = 19) 38 (NS)	Electrolysis (EPI®)	EG: EPI CG1 : DDN CG2: Placebo	3s (1s per week) (3 weeks)	(A) PI (VAS) (B) MMO (Therabite® System ruler) (C) Function (TMJ functionality test)	T0: baseline T1: 28 days T2: 42 days T3: 70 days	EG 1: ↓PI,↑MMO and ↑function EG 2: ↓PI,↑MMO and ↑function CG ↓PI,↑MMO and ↑function EG 1 < EG 2 < CG: ↓PI* EG 1 > EG 2 > CG: ↑MMO and ↑function*	Carlos III Health Institute-Health Research Fund
12	Fernández-Rodríguez et al. (2018) [28] Spain	Heel pain	9/10⁺	University Clinic of the Ultrasound Department, San Francisco de Asís Hospital, Madrid	n = 67 EG = 38 (♂ = 15; ♀ = 23) CG = 29 (♂ = 10; ♀ = 19) 45 (± 11.3)	Microelectrolysis (EPTE®)	EG: EPTE + TE CG: Placebo + TE	5s (1s per week) (5 weeks)	(A) PI (NPRS) (B) Fascia thickness (USG) (C) Function (FAAM)	T0: baseline T1: 1-week follow-up T2: 3-month follow-up T3: 12-month follow-up	EG: ↓PI,↓ fascia thickness and ↑function* CG: ↓PI,↓ fascia thickness and ↑function* EG < CG: ↓PI* EG = CG: fascia thickness* EG > CG: ↑function*	Universidad Camilo Jose Cela provided financial support for the research, authorship, and/or publication.
13	Iborra-Marcos et al. (2018) [29] Spain	Plantar fasciitis	4/10⁺	Avanfi Institute, MadridVirgen de la Paloma Hospital, Madrid	n = 64 EG = 32 (♂ NS; ♀ NS) CG = 32 (♂ NS; ♀ NS) 46 (± NS)	Electrolysis (EPI®)	EG: EPI CG: Corticosteroid injections	10s (1s per week) (10 weeks)	(A) PI (VAS) (B) Fascia thickness (USG) (C) Function (FADI)	T0: baseline T1: 3-week follow-up T2: 6-month follow-up T3: 12-month follow-up	EG: ↓PI,↓ fascia thickness and ↑function* CG: ↓PI,↓ fascia thickness and ↑function* EG < CG: ↓PI* and fascia thickness* EG > CG: ↑function*	Not funded
14	de Miguel Valtierra et al. (2018) [30] Spain	SAIS	9/10⁺	Healthcare center in Madrid	n = 50 EG = 25 (♂ = 12; ♀ = 13) CG = 25 (♂ = 11; ♀ = 14) 55 (± 12.4)	Microelectrolysis (EPTE®)	EG: EPI + MT + TE CG: MT + TE	5s (1s per week) (5 weeks)	(A) PI (NPRS) (B) PPT (ALG) (C) Disability (DASH) (D) Disability (SPADI) (E) Self-reported improvement (GROC)	T0: baseline T1: post-treatment T2: 3-week follow-up T3: 6-month follow-up	EG: ↓PI,↓ disability and ↑PPT* CG: ↓PI,↓ disability and ↑PPT* EG < CG: ↓PI* and↓ disability* EG > CG: ↑PPT*	Not funded
15	Ortiz et al. (2020) [31] Chile	MFPS - MTrPs	9/10⁺	Laboratory of Electrophysical Agents, School of Physical Therapy, Andrés Bello University	n = 48 EG = 24 (♂ = 11; ♀ = 13) CG = 24 (♂ = 12; ♀ = 12) 22 (± 1.7)	Microelectrolysis (MEP®)	EG: MEP + US CG: US	1s	(A) PI (VAS) (B) PPT (ALG)	T0: baseline T1: post-treatment T2: 3-days follow-up T3. 7-days follow-up	EG: ↓PI* and ↑PPT* CG: ↓PI* and ↑PPT* EG < CG: ↓PI* EG > CG: ↑PPT*	Not funded
16	Rodríguez-Huguet et al. (2020) [32] Spain	SAIS	8/10⁺	Santa María Clinic, Cádiz	n = 36 EG = 18 (♂ = 16; ♀ = 2) CG = 18 (♂ = 11; ♀ = 7) 43 (± 9.9)	Microelectrolysis (EPTE®)	EG: EPTE + TE CG: TDN + TE	4s (1s per week) (4 weeks)	(A) PI (NPRS) (B) PPT (ALG) (C) ROM (GNM)	T0: baseline T1: post-treatment T2: 1-month follow-up T3: 12-month follow-up	EG: ↓PI, ↑PPT and ↑ROM* CG: ↓PI, ↑PPT and ↑ROM* EG < CG: ↓PI* EG > CG: ↑PPT* and ↑ROM* (flexion, Internal rotation and extension)	Not funded
17	Rodríguez-Huguet et al. (2020) [33] Spain	Epicondilalgya	8/10**	Santa María Clinic, Cádiz	n = 32 EG = 11 (♂ = 11; ♀ = 0) CG = 13 (♂ = 13; ♀ = 0) 39 (± 13.9)	Microelectrolysis (EPTE®)	EG: EPTE + TE CG: TDN + TE	4s (1s per week) (4 weeks)	(A) PI (NPRS) (B) PPT (ALG) (C) ROM (GNM) (D) QoL (SF-12)	T0: baseline T1: post-treatment T2: 1-month follow-up T3: 12-month follow-up	EG: ↓PI, ↑PPT and ↑ROM* CG: ↓PI, ↑PPT and ↑ROM* EG < CG: ↓PI* EG > CG: ↑PPT,↑ROM and ↑QoL	Not funded
18	Al-Boloushi et al. (2020) [34] Spain	Heel pain	7/10**	Physical Therapy Department, Physical Medicine and Rehabilitation Hospital, Kuwait City	n = 102 EG = 51 (♂ = 15; ♀ = 36) CG = 51 (♂ = 15; ♀ = 36) 48 (± 8.9)	Electrolysis (EPI®	EG: EPI + TE CG: TDN + TE	4s (1s per week) (4 weeks)	(A) PI (VAS) (B) Foot function (FHSQ) (C) Footwear (FHSQ) (D) GFH (FHSQ) (E) QoL (EQ-5D-5L)	T0: baseline T1: post-treatment T2: 2-month follow-up T3: 3-month follow-up T4: 13-month follow-up	EG: ↓PI, ↑Foot function, ↑Footwear, ↑GFH and ↑QoL* CG: ↓PI, ↑Foot function, ↑Footwear, ↑GFH and ↑QoL* CG < EG: ↓PI* EG = CG: ↑Foot function, ↑Footwear, ↑GFH* and ↑QoL*	This research received funding from Ministry of Health Kuwait
19	Calderón-Díez et al. (2020) [35] Spain	Calcaneal tendinopathy	4/10⁺	Faculty of Nursing and Physiotherapy, University of Salamanca	n = 39 EG = 39 (♂ = 33; ♀ = 6) 42.6 (± NS)	Electrolysis (EPI®)	EG: EPI + TE No CG	12s (1s per week) (12 weeks)	(A) PI (VAS) (B) Function (FADI) (C) Function (VISA-A)	T0: baseline T1: post-treatment (12 weeks)	EG: ↓PI* and ↑function*	Not reported
20	de-la-Cruz-Torres et al. (2020) [36] Spain	Chronic soleus injury	4/10**	MVClinic Institute, Madrid	n = 30 EG 1 = 10 (♂ = 1; ♀ = 9) EG 2 = 10 (♂ = 1; ♀ = 9) CG = 10 (♂ = 1; ♀ = 9) 21.0 (± 2.7)	Electrolysis (EPI®)	EG1: EPI EG2: EPI + TE CG: TE	8s (2 per week) (4 weeks)	(A) PI (NPRS) (B) ROM (Lunge test) (C) Function (Endurance test) (D) Function (Heel raise test) (E) ADL (Likert-scale) (F) ADL (DFOS)	T0: baseline T1: post-treatment (4 weeks)	EG 1: ↓PI, ↑ROM, ↑Function* and ↑ADL* EG 2: ↓PI, ↑ROM, ↑Function* and ↑ADL* EG 1 = EG 2 < CG: ↓PI* EG 1 = EG 2 > CG: ↑ROM, ↑Function and ↑ADL*	Not funded
21	Valera-Calero et al. (2021) [37] Spain	Patellofemoral pain	9/10**	Camilo José Cela University, Madrid	n = 15 EG 1 = 5 (♂ = NS; ♀ = NS) EG 2 = 5 (♂ = NS; ♀ = NS) CG = 5 (♂ = NS; ♀ = NS) NS (± NS)	Microelectrolysis (EPTE®)	EG 1: High-intensity electrolysis EG 2: Low-intensity electrolysis CG: DDN	1s (1 week)	(A) PPT (ALG) (B) PI (VAS-SAKPP)	T0: baseline T1: post-treatment T2: follow-up (1 week)	EG 1: ↑PPT* and ↓PI* EG 2: ↑PPT* and ↓PI* CG: ↑PPT* and ↓PI* EG 1 = EG 2 < CG: ↓PI* EG 1 = EG 2 > CG: ↑PPT*	Not reported
22	Lopez-Royo et. al (2021) [38] Spain	Patellar tendinopathy	5/10**	Laboratory of San Jorge University, Zaragoza	n = 48 EG 1 = 16 (♂ = 13; ♀ = 3) CG 1 = 16 (♂ = 14; ♀ = 2) CG 2 = 16 (♂ = 15; ♀ = 1) 32.3 (± 7.1)	Electrolysis (EPI®)	EG: EPI + TE CG 1: DDN + TE CG 2: Sham DDN	4s (1s every 2 weeks) (8 weeks)	(A) PI (VAS) (B) Function (VISA-P) (C) QoL (SF-36)	T0: baseline T1: post-treatment (10 weeks) T2: follow-up (22 weeks)	EG 1: ↓PI, ↑Function and ↑QoL* CG 1: ↓PI, ↑Function and ↑QoL* CG 2: ↓PI, ↑Function and ↑QoL* EG > CG 1 > CG 2: ↓PI* EG > CG 1 > CG 2: ↑Function* and ↑QoL*	Not reported
23	Fernandez-Sanchis et al. (2022) [39] Spain	Patellar tendinopathy	4/10**	Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego	n = 42 EG 1 = 14 (♂ = NS; ♀ = NS) CG 1 = 13 (♂ = NS; ♀ = NS) CG 2 = 15 (♂ = NS; ♀ = NS) 32.5 ± (7.1)	Electrolysis (EPI®)	EG: EPI + TE CG 1: DDN + TE CG 2: Sham DDN + TE	4s (8 weeks)	(A) QoL (SF-36) (B) QALY (SF-6D)	T0: baseline T1: post-treatment (8 weeks)	EG: ↑QALY (SF-6D)* CG 1: ↑QALY (SF-6D)* CG 2: ↑QALY (SF-6D) EG > CG 1 > CG 2: ↑QALY (SF-6D)*	Not funded
24	Benito-de-Pedro et al. (2023) [40] Spain	MFPS - MTrPs	9/10⁺	The Physiotherapy and Podiatry Clinic FISIOFUENLA	n = 52 EG = 26 (♂ NS; ♀ NS) CG = 26 (♂ NS; ♀ NS) 39 (± 9.4)	Electrolysis (EPI®)	EG: EPI CG: DDN	1s	(A) PI (VNPS) (B) PPT (ALG) (C) ROM (GNM) (D) Disability (NPQ)	T0: baseline T1: post-treatment T2: 3-day follow-up T3: 14-day follow-up	EG: ↓PI, ↑PPT, ↑ROM* and ↓disability* CG: ↓PI, ↑PPT, ↑ROM* and ↓disability* EG = CG: ↓PI, ↑PPT and ↓disability* EG > CG: ↑ROM*	Not funded
25	De-la-Cruz-Torres et al. (2023) [41] Spain	Chronic soleus injury	6/10⁺	Department of Physiotherapy, University of Seville	n = 20 EG = 10 (♂ NS; ♀ = 10) CG = 10 (♂ NS; ♀ = 10) 22.4 (± 4.9)	Electrolysis (EPI®)	EG: EPI + TE CG: Placebo + TE	2s (2 weeks)	(A) PI (NPRS) (B) ROM (Lunge test) (C) Function (Heel raise test) (D) Disability (CS) (E) Self-improvement (GRCS)	T0: baseline T1: post-treatment (4 weeks)	EG: ↓PI, ↑ROM, ↑function* and ↓disability* CG: ↓PI, ↑ROM, ↑function* and ↓disability* EG = CG: ↓PI, ↑ROM, ↑function and ↓disability	Not reported
26	Góngora-Rodríguez et al. (2024) [42] Spain	SAIS	9/10⁺	Department of Nursing and Physiotherapy, University of Cádiz	n = 50 EG = 25 (♂ 19; ♀ 6) CG = 25 (♂ 17; ♀ 8) 44.2 (± 11.8)	Microelectrolysis (EPTE®)	EG: EPTE + PNS + TE CG: TENS + US + TE	4s (1s per week) (4 weeks)	(A) PI (NPRS) (B) Shoulder strength (DNM) (C) Tendon thickness (USG) (D) Disability (DASH) (E) Disability (SPADI) (F) Muscle activity (EMG)	T0: baseline T1: post-treatment T2:follow-up (12 weeks) T3: follow-up (24 weeks)	EG: ↓PI, ↓Tendon thickness, ↓disability,↑Shoulder strength and ↑muscle activity* CG: ↓PI, ↓Tendon thickness, ↓disability,↑Shoulder strength and ↑muscle activity* EG < CG: ↓PI, ↓Tendon thickness and ↓disability* EG > CG: ↑Shoulder strength* and ↑muscle activity*	Not funded
27	Di Gesù et al. (2024) [43] Italy	Calcaneal tendinopathy	7/10⁺	Health Center Mya Salute, Palermo	n = 50 EG = 25 (♂ 15; ♀ 10) CG = 25 (♂ 17; ♀ 8) 40.9 (± 12.5)	Electrolysis (EPI®)	EG: EPI + TE CG: TE	3s (1s per week) (3 weeks)	(A) PI (VAS) (B) Function (VISA-A)	T0: baseline T1: post-treatment (6 weeks) T2:follow-up (4 weeks) T3: follow-up (8 weeks)	EG: ↓PI* and ↑function* CG: ↓PI* and ↑function* CG < EG: ↓PI CG > EG: ↑function	Not funded
28	Rodríguez-Huguet (2024) [44] Spain	Epicondilalgya	9/10⁺	Santa María Clinic, Cádiz	n = 40 EG = 20 (♂ 13; ♀ 7) CG = 20 (♂ 12; ♀ 8) 40.2 (± 12.7)	Microelectrolysis (EPTE®)	EG: EPTE + VT + TE CG: MT + US + TE	4s (1s per week) (4 weeks)	(A) PI (NPRS) (B) PPT (ALG) (C) ROM (GNM) (B) Disability (PRTEE)	T0: baseline T1: post-treatment T2: 1-month follow-up T3: 3-month follow-up	EG: ↓PI, ↑PPT, ↑ROM* and ↓disability* CG: ↓PI, ↑PPT, ↑ROM* and ↓disability* CG < EG: ↓PI* and ↓disability* CG > EG: ↑PPT* and ↑ROM*	Not funded

Percutaneous electrolysis and microelectrolysis for musculoskeletal pain management: milliamps or microamps? An evidence-based comparison through systematic review and meta-analysis

Figures & Tables

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Summary of findings and quality of evidence (GRADE) for interesting outcomes

Electrolysis and microelectrolysis parameters

Characteristics of the studies included in the present meta-analysis

Paradigm

My account