Abstract / Summary
Background and purpose: To evaluate the effectiveness of percutaneous electrolysis (PNE), alone or combined with therapeutic exercise (TE), on pain intensity and function in patients with tendinopathy or myofascial pain syndrome.
Methods: A systematic review with meta-analysis was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251238941). Searches were performed in PubMed, Web of Science, and PEDro from inception to November 2025, in accordance with the PRISMA guidelines. Randomized controlled trials comparing PNE with sham, control, or dry needling (DN) interventions were included. Pain intensity and function were analyzed using random-effect meta-analyses, and the certainty of evidence was assessed using GRADE.
Results/findings: Thirteen trials were included in the qualitative synthesis and twelve in the meta-analysis. In tendinopathies, very low-certainty evidence indicated that adding PNE to TE was not superior to sham plus TE or TE alone for pain or function at short-, medium-, or long-term follow-up. Low-certainty evidence showed that PNE combined with TE resulted in greater short- and medium-term pain reduction compared with DN plus TE without functional superiority. In myofascial pain syndrome, low to very low-certainty evidence demonstrated no significant differences between PNE and DN for pain or function at any follow-up.
Implications for physiotherapy practice: Current evidence does not support the superiority of PNE over sham or control interventions when added to therapeutic exercise. PNE may provide short- to medium-term pain benefits compared with DN in tendinopathy but not in myofascial pain syndrome. Further high-quality trials are required to clarify its clinical role.
Trail registration: The protocol of this study was registered in PROSPERO (PROSPERO registration: CRD420251238941).