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. 2022 May 20;11(10):2889.
doi: 10.3390/jcm11102889.

Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial

Sergio Varela-Rodríguez  1 , José Luis Sánchez-Sánchez  1 , Enrique Velasco  2 , Miguel Delicado-Miralles  2 , Juan Luis Sánchez-González  1
Affiliations

Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial

Sergio Varela-Rodríguez et al. J Clin Med. .

Abstract

The purpose of this double-blinded randomized controlled trial was to investigate whether percutaneous electrolysis (PE) is able to activate endogenous pain modulation and whether its effects are dependent on the dosage of the galvanic current. A total of 54 asymptomatic subjects aged 18-40 years were randomized into three groups, receiving a single ultrasound-guided PE intervention that consisted of a needle insertion on the lateral epicondyle tendon: sham (without electrical current), low-intensity (0.3 mA, 90 s), and high-intensity (three pulses of 3 mA, 3 s). Widespread pressure pain thresholds (PPT), conditioned pain modulation (CPM), and temporal summation (TS) were assessed in the elbow, shoulder, and leg before and immediately after the intervention. Both high and low intensity PE protocols produced an increase in PPT in the shoulder compared to sham (p = 0.031 and p = 0.027). The sham group presented a significant decrease in the CPM (p = 0.006), and this finding was prevented in PE groups (p = 0.043 and p = 0.025). In addition, high-intensity PE decreased TS respect to sham in the elbow (p = 0.047) and both PE groups reduced TS in the leg (p = 0.036 and p = 0.020) without significant differences compared to sham (p = 0.512). Consequently, a single PE intervention modulated pain processing in local and widespread areas, implying an endogenous pain modulation. The pain processing effect was independent of the dosage administrated.

Keywords: electrical stimulation; pain management; pain threshold; percutaneous electrolysis; postsynaptic potential summation; randomized controlled trial.

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Conflict of interest statement

J.L.S.-S. is a recognized teacher of percutaneous electrolysis technique among physical therapists in Spain. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Ultrasound imaging of the application of percutaneous electrolysis in the common extensor tendon of the lateral epicondyle.
Figure 2
Figure 2
Study methodology illustration. (A) The needle intervention, the three PE protocols application, and the representation of the intensity variation through the intervention duration depending of the PE group. (B) The outcomes assessment timeline, location, and methodology applied. PPT, Pressure Pain Threshold; CPM, Conditioned Pain Modulation; and TS, Temporal Summation.
Figure 3
Figure 3
CONSORT flow diagram.
Figure 4
Figure 4
Pressure pain threshold (A), conditioned pain modulation (B), and temporal summation (C) measured in the three locations assessed. Individual data are presented as grey lines, and colored line represents mean ± SD. Asterisks indicates significations for between-group comparisons (p < 0.05; Bonferroni post hoc test or Mann–Whitney U test).
See this image and copyright information in PMC

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