Percutaneous Electrolysis or Exercise? It's Not One or the Other, It's Knowing When
In recent weeks a recurring debate in physiotherapy has reopened on social media: is percutaneous electrolysis worth anything if we're already doing exercise? Framed that way, it sounds like a contest between two treatments. But in a real injury it's more like asking whether a building site needs the crane or the builders: it depends on what's being built and what stage the work is at.
It's not electrolysis versus exercise: it's electrolysis with exercise
Let's start with what isn't up for debate: exercise is the foundation of treatment for tendinopathies and musculoskeletal injuries. Tendons, muscles, ligaments and spinal discs adapt to load through mechanotransduction, those “sensors” scattered around the building site that tell head office the structure needs reinforcing. No technique replaces that stimulus. In this video I talk about mechanotransduction: https://youtu.be/QyeEpMduoR8?si=S4kNIcxTC9a1Uwug
Electrolysis has a different role: helping tissue whose repair process has stalled, so that exercise has something to work with. The evidence for that role is still limited and doesn't always agree. A meta-analysis published in Journal of Sport Rehabilitation (2024) found that ultrasound-guided electrolysis reduced pain in tendinopathies, with mostly low certainty of evidence. A recent review in Physiotherapy Research International (Novaková et al., 2026) found no advantage from adding it to exercise versus exercise alone, with very low certainty, although it did find less pain in the short and medium term than with dry needling. With results this mixed, the useful question isn't whether electrolysis works in general, but in which patient, in which tissue, and at what dose.
First question: which tissue, and at what phase of the injury?
As we explain in Inflammation: A Natural Healing Process, all repair goes through three phases (video here if you want to know more: https://youtu.be/5rYQeVB8RPM?si=JG5PrFC28Gps-Zab). First the emergency crew arrives (inflammatory phase) to stop leaks, carry out rescue, secure damaged structures, and so on. Then the builders raise the structure with provisional type III collagen scaffolding (proliferative phase). Finally, the finishing crew replaces that scaffolding with type I collagen, the definitive, resilient material (remodelling phase).
In many chronic tendinopathies, such as tennis elbow (epicondylitis), jumper's knee (patellar tendinopathy) or the Achilles tendon, and in the fibrosis sometimes left by a muscle tear, the building work has stalled halfway through, either from overusing anti-inflammatory medication or from not respecting the signals of each phase and adapting training or work load to the tissue's capacity at that moment. That's where electrolysis makes sense: triggering a local, controlled response that gets the building work moving again in the precise area. In an animal model of induced tendinopathy in rats (Abat et al., 2014), a single electrolysis session increased molecules related to the anti-inflammatory response and the formation of new vessels. This is preclinical evidence: it helps explain the why, but it doesn't guarantee the result in people.
By contrast, in an acute injury where the emergency crew is already at work, there's no point calling in more firefighters. That's why at KINEO Benidorm real-time ultrasound is the first step: it lets us see the state of the tissue before deciding whether the technique is indicated.
Second question: what dose and what type of current?
Talking about “electrolysis” without any more detail is like talking about using “a medication” without saying when to use it, how much, or when to stop. EPTE works at low intensity (microamps) for longer and is practically painless; EPI uses high intensity (milliamps) for a short time and is more uncomfortable, although a higher dose (within certain limits) does appear to generate a greater biological response. The mechanism is the same, but the dose changes. A meta-analysis published in Frontiers in Medicine (Sánchez-González et al., 2023) found still-weak evidence that low intensity might reduce musculoskeletal pain more than high intensity.
And there's a third option that's rarely talked about: microcurrents. The EPTE system can apply them with a needle, ultrasound-guided, to support the tissue's proliferation and maturation phases rather than reactivating it. A review published in Advances in Rehabilitation (2024) observed reductions in pain and disability with both electrolysis and microelectrolysis, with a particularly marked effect for the latter. More studies are needed, but lumping together such different currents, doses and phases doesn't help much in understanding what works, and for whom.
At KINEO Benidorm we don't use EPTE as a stand-alone treatment. We always apply it ultrasound-guided, only when the assessment shows the tissue and phase justify it, and within a progressive exercise programme, which is what actually consolidates recovery. If you'd like to go deeper, you can read about how EPTE and EPI differ or learn about our invasive EPTE physiotherapy service in Benidorm.
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