Effect of percutaneous electrolysis combined with exercise on pain and function in chronic lateral epicondylitis: A randomized controlled trial

Percutaneous electrolysis (PE) is a minimally invasive, ultrasound-guided treatment, but its added benefit alongside exercise for chronic lateral epicondylitis remains unclear.

To compare exercise plus PE with exercise alone for pain and function.

Prospective randomized controlled trial.

In an outpatient rehabilitation clinic, 68 participants were randomized to exercise plus PE (n = 34) or exercise alone (n = 34). Both groups performed a 2-week home-based stretching and strengthening program; PE was administered on days 1, 8, and 14. The primary outcome was pain intensity on a 0-10 visual analog scale (VAS); secondary outcomes were Patient-Rated Tennis Elbow Evaluation (PRTEE) total score, pressure pain threshold (PPT), and Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score. Assessments occurred at baseline and 1 week, 1 month, and 3 months after treatment completion.

Group-by-time interactions were significant for all outcomes (all p < 0.001). At 3 months, model-estimated between-group mean differences favored PE for VAS (-3.30 points; 95% CI, -3.97 to -2.63) and PRTEE (-20.78 points; 95% CI, -25.98 to -15.57), both p < 0.001. Secondary outcomes favored PE at all follow-ups. In a post hoc exploratory responder analysis, clinically meaningful PRTEE improvement occurred in 79.4% of the PE group versus 2.9% of controls (p < 0.001). No serious adverse events or intervention-related discontinuations occurred.

Adding ultrasound-guided PE to the tested 2-week home exercise program was associated with greater improvements in pain and function than exercise alone over the 3-month follow-up. Longer-term effects and applicability to other rehabilitation programs remain uncertain.

ClinicalTrials.gov, NCT07277127.