Varela-Rodríguez Sergio, Sánchez-Sánchez José Luis, Velasco Enrique, Delicado-Miralles Miguel, Sánchez-González Juan Luis
Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain.
Instituto de Neurociencias de Alicante (CSIC-UMH), 03550 Alicante, Spain.
J Clin Med. 2022 May 20;11(10):2889. doi: 10.3390/jcm11102889.
The purpose of this double-blinded randomized controlled trial was to investigate whether percutaneous electrolysis (PE) is able to activate endogenous pain modulation and whether its effects are dependent on the dosage of the galvanic current. A total of 54 asymptomatic subjects aged 18-40 years were randomized into three groups, receiving a single ultrasound-guided PE intervention that consisted of a needle insertion on the lateral epicondyle tendon: sham (without electrical current), low-intensity (0.3 mA, 90 s), and high-intensity (three pulses of 3 mA, 3 s). Widespread pressure pain thresholds (PPT), conditioned pain modulation (CPM), and temporal summation (TS) were assessed in the elbow, shoulder, and leg before and immediately after the intervention. Both high and low intensity PE protocols produced an increase in PPT in the shoulder compared to sham ( = 0.031 and = 0.027). The sham group presented a significant decrease in the CPM ( = 0.006), and this finding was prevented in PE groups ( = 0.043 and = 0.025). In addition, high-intensity PE decreased TS respect to sham in the elbow ( = 0.047) and both PE groups reduced TS in the leg ( = 0.036 and = 0.020) without significant differences compared to sham ( = 0.512). Consequently, a single PE intervention modulated pain processing in local and widespread areas, implying an endogenous pain modulation. The pain processing effect was independent of the dosage administrated.
这项双盲随机对照试验的目的是研究经皮电解(PE)是否能够激活内源性疼痛调节,以及其效果是否依赖于直流电的剂量。总共54名年龄在18至40岁之间的无症状受试者被随机分为三组,接受单次超声引导下的PE干预,该干预包括在肱骨外上髁肌腱处插入一根针:假手术组(无电流)、低强度组(0.3 mA,90秒)和高强度组(三个3 mA的脉冲,3秒)。在干预前和干预后立即评估肘部、肩部和腿部的广泛压痛阈值(PPT)、条件性疼痛调节(CPM)和时间总和(TS)。与假手术组相比,高强度和低强度的PE方案均使肩部的PPT升高(P = 0.031和P = 0.027)。假手术组的CPM显著降低(P = 0.006),而PE组中这一结果得到了预防(P = 0.043和P = 0.025)。此外,高强度PE使肘部的TS相对于假手术组降低(P = 0.047),并且两个PE组均使腿部的TS降低(P = 0.036和P = 0.020),与假手术组相比无显著差异(P = 0.512)。因此,单次PE干预调节了局部和广泛区域的疼痛处理,这意味着存在内源性疼痛调节。疼痛处理效果与所给予的剂量无关。