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Study Summary
Background
Myofascial pain syndrome (MPS) affects 30-85% of patients seeking care for musculoskeletal pain, causing significant disability and economic burden. Traditional treatments often provide only partial relief. This systematic review examined percutaneous needle electrolysis (PNE) and intramuscular electrical stimulation (IMES) as emerging therapies. PNE applies galvanic current through needles to soft tissues, while IMES delivers low-frequency electrical current through needles directly to muscle tissue.
Both techniques target trigger points and aim to modulate pain pathways.
What They Did
Researchers searched multiple databases through March 2026, identifying 30 studies with over 1000 participants total. They included randomized and controlled trials comparing PNE or IMES to sham procedures, other interventions, or standard care in adults with MPS or tendinopathies. Primary outcomes were pain intensity, functional improvement, and neuromuscular performance. Secondary outcomes included pressure pain threshold, adverse events, and quality of life.
Two reviewers independently assessed study quality using established bias assessment tools.
What They Found
PNE generally showed effectiveness for pain reduction in tendinopathies and MPS, with significant improvements in pain intensity across multiple conditions including supraspinatus tendinopathy, temporomandibular myofascial pain, and plantar fasciopathy. Range of motion improvements were frequently observed. However, results varied - some studies found PNE comparable to dry needling or showed no superiority over sham procedures. IMES demonstrated moderate evidence for pain reduction and enhanced function, particularly improving cervical range of motion and pressure pain thresholds.
Both interventions showed inconsistent results for disability indices and quality of life measures. Adverse events were minor and self-limiting, including temporary muscle soreness and occasional small hematomas. Most studies had high risk of bias due to inability to blind participants to electrical stimulation.
What This Means
PNE and IMES may offer clinically meaningful benefits for pain and some functional outcomes in myofascial pain and tendinopathies. Both appear safe when performed by trained clinicians. However, the evidence quality limits confidence in recommendations. Many studies combined these techniques with exercise or manual therapy, making it unclear whether benefits come from the electrical component alone.
Clinicians should consider these techniques as part of multimodal treatment approaches rather than standalone solutions. Patients can expect potential pain relief and improved mobility, but results may vary. Higher-quality studies with better blinding strategies are needed to establish definitive effectiveness.
- Studies Included
- 30
- Total Participants
- 1000+
- High Risk of Bias
- 16/30
- MPS Prevalence in Pain Patients
- 30-85%
Key Findings
| Finding | Detail | Impact |
|---|---|---|
| PNE showed effectiveness for pain reduction in multiple conditions | Significant improvements in supraspinatus tendinopathy, temporomandibular pain, and plantar fasciopathy compared to controls | High |
| IMES demonstrated benefits for cervical range of motion | Consistently improved cervical ROM and pressure pain thresholds across multiple studies | Medium |
| Both techniques had favorable safety profiles | Adverse events were minor and self-limiting, including temporary muscle soreness and occasional hematomas | High |
| Evidence quality was limited by high risk of bias | 16 out of 30 studies rated as high risk of bias, primarily due to inability to blind participants | High |
| Results were inconsistent across different outcome measures | While pain often improved, disability indices and quality of life measures showed mixed results | Medium |
| Many studies evaluated combined interventions | PNE and IMES often studied as adjuncts to exercise or manual therapy, making isolated effects unclear | Medium |
Strengths
- Comprehensive search across multiple databases and clinical trial registries
- Systematic assessment of risk of bias using established tools
- Large total sample size across 30 included studies
- Evaluation of both effectiveness and safety outcomes
Limitations
- High risk of bias in most studies due to inability to blind participants
- Substantial heterogeneity in treatment protocols and outcome measures
- Many studies combined interventions, making isolated effects unclear
- Limited long-term follow-up data in most studies
Key Takeaways for Patients
What This Means for You
PNE and IMES are needle-based treatments that use electricity to target muscle pain and tendon problems
Both treatments may help reduce pain and improve movement, but results can vary between individuals
Side effects are typically minor and temporary, such as muscle soreness that resolves within 1-2 days
These treatments work best when combined with exercise therapy rather than used alone
While promising, more high-quality research is needed to fully establish their effectiveness
Read the Full Paper
Access the complete peer-reviewed study from Journal of Clinical Medicine