Percutaneous Electrolysis for Musculoskeletal Disorders Management in Rehabilitation Settings: A Systematic Review

Abstract

Background: Percutaneous electrolysis (PE) is a minimally invasive procedure that utilizes galvanic current delivered through a needle. PE is increasingly employed for musculoskeletal disorders, despite the scarcity of scientific evidence supporting its use. The aim of this systematic review is to synthesize the existing evidence and explore the applications of PE in rehabilitation. Methods: In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted across the PubMed, Web of Science, Scopus, and PEDro databases from inception to July 2025. The search strategy employed the term "Percutaneous Electrolysis" without applying additional filters or time restrictions, ensuring a comprehensive search. Cited references from screened articles were also evaluated for potential inclusion. Studies were included if they met the following criteria: peer-reviewed articles, intervention-based research, relevance to the topic, and publication in English. Results: Of the 181 papers retrieved, 143 were excluded for various reasons, leaving 38 studies. The evidence suggests that PE appears effective in reducing pain and improving function, particularly when combined with exercises such as eccentric training or stretching, though inconsistencies in protocols and patient characteristics, along with unclear mechanisms, show that it warrants further investigation. Conclusions: In conclusion, while PE emerges as a promising therapeutic strategy for musculoskeletal disorders, its full integration into rehabilitation practice necessitates further rigorous research to standardize treatment protocols, elucidate the underlying mechanism, and validate its cost-effectiveness. These steps are essential to establish PE as a robust and evidence-based option within the field of rehabilitation.

Keywords: Electrolysis Percutaneous Intratissue (EPI); Percutaneous Electrolysis Therapy (EPTE); elbow Tendinopathy; electroacupuncture; muscle injury; patellar Tendinopathy; physiatry; plantar fasciitis; plantar heel pain.

Figure 1

Study flowchart.

Figure 2

Risk of bias summary: review authors’ judgements about each risk of bias item for each included study. Green dots with “+”: low risk of bias; red dots with “−”: high risk of bias; white square: unclear risk. Al-Boloushi [40], Arias-Buría [55], Benito-de-Pedro [51], De la Cruz Torres (2016) [34], De la Cruz Torres (2020) [47], De Miguel Valtierra [54], Doménech-García [60], Fernández [41], Fernández-Rodriguez [39], Fernández-Sanchis [36], García Naranjo [42], Góngora-Rodríguez [57], Lopez-Martos [58], López-Royo (2021) [33], López-Royo (2024) [59], Moreno [43], Rodríguez–Huguet (2020-1) [49], Rodríguez-Huguet (2020-2) [56], Rodríguez-Huguet (2024) [50], Sánchez–González [44], Valera–Calero [37], Varela–Rodríguez [1].