Efficacy of different intensities of percutaneous electrolysis for musculoskeletal pain: A systematic review and meta-analysis

OBJECTIVE: A meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effect of ultrasound-guided percutaneous electrolysis (PE) alone or as an adjunct to other interventions on pain intensity generated by musculoskeletal disorders, depending on the intensity of the technique. DATA SOURCES: PUBMED, EMBASE, Cochrane Library, Web of Science, SCOPUS, Health Medical Collection, and CINALH from inception to September 2022 were searched to identify documents. STUDY SELECTION: Publications investigating the effect of ultrasound-guided PE in musculoskeletal pain. DATA EXTRACTION: Data were extracted into predesigned data extraction and tables. Risk of bias was evaluated with the Cochrane Risk of Bias Tool (Rob 2.0). Thirteen articles met inclusion criteria. DATA ANALYSIS: Random-effects meta-analysis models were used to quantify the difference in pain between the PE and control groups. DATA SYNTHESIS: A significant reduction in pain was found in favor of low- (−1.89; 95% CI: −2.69; −1.10; p < 0.001) and high-intensity PE (−0.74; 95% CI: −1.36; −0.11; p: 0.02) compared to control group. Low-intensity PE showed significant reduction in pain in the short (−1.73; 95% CI: −3.13; −0.34; p < 0.02) and long term (−2.10; 95% CI: −2.93; −1.28; p = 0.005), with large effect sizes compared to control group. High-intensity PE only showed significant lower pain than control group in the long term (−0.92; 95% CI: −1.78; −0.07; p < 0.03), with a small effect size, but not in the short term. CONCLUSION: We found small evidence suggesting that low-intensity PE could be more effective for musculoskeletal pain reduction than high-intensity PE. Nevertheless, scientific evidence on this subject is still scarce and studies comparing the two modalities are warranted. SYSTEMATIC REVIEW REGISTRATION: www.crd.york.ac.uk/prospero, identifier CRD42022366935.