Treatment of Tendinopathies with Percutaneous Electrolysis Therapy (EPTE)

Tendinopathy is a chronic injury caused by excessive mechanical stress, characterised by tendon degeneration accompanied by pain and reduced activity. Tendinopathy is very common in the general population and particularly among athletes, accounting for more than 50% of all sports injuries.

The term “tendinopathy” is generally used to describe tendon disorders that include acute tendinitis as well as chronic tendinosis. From acute tendinitis to chronic tendinosis, it is important to recognise that each stage of the tendinopathy process involves specific anatomical changes and that each stage of the condition may respond differently to various treatment modalities.

Tendinitis refers to inflammation of the tendon resulting from microtrauma occurring at the musculotendinous junction, which is acutely overloaded by tensile force applied too suddenly. Tendinitis may last for up to three weeks, after which tendinosis may develop.

Tendinosis is characterised by the chronic progression of a degenerative process, including the formation of fibrous scar tissue at the site of injury with reduced capillary blood flow, leading to the stagnation of inflammatory cells (neutrophils and macrophages) required for phagocytosis.

Percutaneous Electrolysis Therapy (EPTE) is an innovative technique used in the treatment of tendinopathies. This ultrasound-guided technique applies electrical stimulation to the injured tendon through an acupuncture needle in order to produce a localised inflammatory response at the treatment site and thereby stimulate tendon healing.

The application of electrical stimulation (galvanic current) at the site of scar tissue creates controlled microtrauma with non-thermal electrochemical ablation of the degenerated tendon tissue. This process leads to the production of sodium hydroxide molecules, which alters the pH at the site of injury (creating an alkaline environment) and increases the oxygen concentration in the treated area, thereby promoting phagocytosis and activating tendon regeneration.

Indications for EPTE Therapy:

• Plantar fasciitis
• Achilles tendinopathy
• Quadriceps tendinopathy
• Medial epicondylitis
• Lateral epicondylitis
• Shoulder tendinopathies

Contraindications for EPTE Therapy:

• Patients with cancer
• Pregnancy
• Pacemakers
• Orthopaedic prostheses

Conditions and Symptoms Treated with EPTE Therapy:

• Foot pain
• Achilles tendon pain
• Knee pain
• Elbow pain
• Shoulder pain

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