Efficacy of percutaneous electrolysis in upper limb tendinopathies: a systematic review

Systematic Reviews Open access Published: June 22, 2026

Vol. 2 No. 1 (2026) Pages: e26 https://doi.org/10.63360/ipmm.v2.e26

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Abstract

Introduction: Upper limb tendinopathies are a frequent cause of pain and disability. Percutaneous electrolysis (PE), applied under ultrasound guidance, is proposed as an invasive technique to modulate pain and support tissue repair.

Objectives: To determine the efficacy of percutaneous electrolysis in reducing pain and its effects on function, strength, joint range, pain to pressure threshold (PPT), potential ultrasound findings, and dosage.

Methods: A PRISMA review was conducted in PubMed, PEDro, Web of Science, and Cochrane. Inclusion criteria: adults with upper limb tendinopathy treated with percutaneous electrolysis, in whom at least one pain-related outcome measure was assessed. Exclusion criteria: cadaver, lower limb studies, non-inclusion of pain measurement, publications other than English, French, or Spanish. Quality was assessed using RoB2 (RCTs) and MINORS (non-randomized).

Results: We included 7 studies (RCTs, n=32-50; longitudinal study, n=36), with follow-up periods of up to 1 year. PE showed a significant reduction in pain in all studies, with more consistent results in the shoulder. Function improved significantly in most studies, with clinically relevant effects. Increases in strength, electromyographic activity, and ROM were observed, especially in the shoulder. The PPT showed heterogeneous results. Satisfaction was higher in the PE groups, and ultrasound changes showed early improvements in hypervascularization and later structural changes.

Discussion: In adults with upper limb tendinopathies, percutaneous electrolysis is a useful adjunct to exercise to achieve early analgesia, while functional gains seem to depend mainly on the exercise program. The heterogeneity of protocols and the risk of bias suggest that it should be considered adjuvant, not substitutive, and that RCTs with standardized dosimetry, a well-defined anatomical target, and 12-month follow-up ≥should be prioritized.

Conclusions: Percutaneous electrolysis can be considered an effective complement for modulating pain in upper-limb tendinopathies, but its contribution is secondary to exercise and requires validation in studies with greater methodological control.

Keywords

  • percutaneous intratissue electrolysis
  • tendinopathy
  • upper limb
  • pain
  • functionality

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References

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