Ultrasound-guided percutaneous electrolysis improved pain, function, and quality of life more than dry needling in patients with Achilles tendinopathy, according to a randomized clinical trial published in Cureus.
In the single-blind trial, researchers in Spain randomly assigned 60 patients with Achilles tendinopathy to receive either dry needling of gastrocnemius muscle trigger points or ultrasound-guided percutaneous electrolysis applied directly to the Achilles tendon. Both groups underwent four weekly treatment sessions and followed the same stretching and eccentric strengthening program.
Outcomes were assessed at baseline and weekly for one month, including pain intensity (visual analog scale), pressure pain threshold, ankle dorsiflexion range of motion, quality of life (Victorian Institute of Sport Assessment-Achilles), and function (Foot and Ankle Ability Measure).
Pain decreased in both groups over time, but reductions were greater in the percutaneous electrolysis group. Differences between groups were evident after the first treatment and persisted through week four, with consistently lower pain scores among patients who received electrolysis.
Pressure pain threshold also improved over time in both groups, with greater increases in the electrolysis group beginning at week two.
Functional outcomes followed a similar pattern. Quality of life and functional scores improved in both groups, with significantly greater gains in the electrolysis group from week two onward. Improvements were observed in both daily activities and sports-related function.
Ankle dorsiflexion changed over time overall; however, improvements were observed primarily in the electrolysis group beginning at week two, while the dry needling group showed no significant change.
The study population had a mean age in the mid-40s, and baseline characteristics were similar between groups. Patients had insertional, midportion, or mixed Achilles tendinopathy with symptoms lasting at least four weeks.
The researchers used repeated-measures analysis to evaluate changes over time and differences between groups. The interventions targeted different anatomical structures, with dry needling applied to calf muscle trigger points and electrolysis delivered directly to the tendon under ultrasound guidance.
Limitations include the modest sample size, short follow-up period of one month, and potential variability in patient populations recruited from both clinical and sports settings. Additionally, the use of different anatomical targets for each intervention may affect comparability.
“Ultrasound-guided percutaneous electrolysis…is more effective than dry needling…in reducing pain intensity and improving quality of life and ankle and foot function,” Sara Delgado Álvarez, PT, of Universidad Católica de Ávila, and colleagues concluded.
The study authors reported no funding and no conflicts of interest.
Source: Cureus
