Immediate effects of percutaneous electrical nerve stimulation in patients with lateral elbow pain

Physiother Theory Pract. 2023 Dec 26:1-12. doi: 10.1080/09593985.2023.2296063. Online ahead of print.

Abstract

Introduction: Ultrasound guided-percutaneous electrical nerve stimulation appears to be effective in the treatment of chronic musculoskeletal pain.

Objective: To investigate the immediate effects of one session of percutaneous electrical nerve stimulation on the radial nerve in patients with lateral elbow pain.

Methods: A randomized clinical trial was conducted. Sixty patients with chronic lateral elbow pain were allocated into real-percutaneous electrical nerve stimulation (n = 30) or sham-percutaneous electrical nerve stimulation (n = 30) where the patients received one-single session of the real or sham percutaneous stimulation on the radial nerve, respectively. Pressure pain thresholds, pain intensity, pain-free grip strength, and the self-perceived improvement were evaluated after the intervention.

Results: Significant differences between groups for pain intensity (-11.55, 95% CI -21.79 to -1.30, p < .028), but not for pressure pain threshold or pain-free grip strength, were found. Patients receiving real-percutaneous stimulation had significant improvement in pain-free grip strength on the treated side. The proportion of individuals reporting moderate to large self-perceived improvement (≥4) was significantly higher (p = .026) after real-percutaneous stimulation than after sham-percutaneous stimulation.

Conclusion: A single session of real-percutaneous electrical nerve stimulation targeting the radial nerve in subjects with lateral elbow pain decreased pain intensity between groups and increased pain-free grip strength on the treated side but not between groups.

Keywords: Lateral elbow pain; percutaneous electrical nerve stimulation; pressure pain threshold; radial nerve.