Long-Term Benefits of Ultrasound-Guided Percutaneous Electrical Nerve Stimulation for Chronic Lateral Elbow Pain: A Randomized Controlled Trial.
Daniel Albert-Lucena, Gabriel Rabanal-Rodríguez, Marcos José Navarro-Santana et al.
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In 30 seconds
This randomized, double-blinded, sham-controlled trial evaluated ultrasound-guided percutaneous electrical nerve stimulation (PENS) targeting the radial nerve, combined with exercise, in 49 participants with chronic lateral elbow pain. Participants received a 4-week exercise program with weekly PENS or sham sessions, with outcomes assessed over 1 year. PENS significantly outperformed sham across primary and secondary outcomes. Reported improvements included a 25.5-point reduction in Numeric Pain Rating Scale scores and a 25.4-point reduction in Patient-Rated Tennis Elbow Evaluation scores; more than 90% reported moderate to large improvement at 1 year.
Key findings
- Pain improved by 25.5 points on the Numeric Pain Rating Scale in the PENS group, with significantly better outcomes than sham.
- Patient-Rated Tennis Elbow Evaluation scores improved by 25.4 points, and Disabilities of the Arm, Shoulder, and Hand scores by 24.5 points.
- More than 90% of PENS recipients reported moderate to large perceived improvement at 1-year follow-up.
- Psychological outcomes also improved, and no serious adverse events were reported.
Why it matters
Chronic lateral elbow pain can involve pain-related disability and psychological factors as well as symptoms. This trial suggests that adding radial-nerve PENS to exercise may yield sustained improvements across these domains, with benefits reported through 1 year. The sham-controlled design and patient-reported outcomes make the findings relevant to evaluating this approach, while the results remain specific to the tested intervention and population.
What to keep in mind
The trial included 49 participants, limiting the precision and generalisability of its findings.