Ultrasound-guided intratissue percutaneous electrolysis (EPI) technique is a minimally invasive approach that has been used in the treatment of chronic tendinopathy.
We describe this technique and present our institution’s experience with EPI procedure in the treatment of plantar fasciitis.
Ultrasound-guided EPI procedure is a simple technique which consists in the application of a galvanic current through tendons.
This produces a non-thermal electrochemical reaction on degenerated tissue,
leading to an inflammatory process,
increasing oxidative stress and cell death in the first days after treatment1.
This process enables fagocitosis,
leading to a faster tendon injury recovery,
with rapid regeneration2.
EPI technique has been used in sports medicine and in the treatment of several conditions such as patellar and Achilles tendinopathy and epicondylitis with favourable results3,
Findings and procedure details
Ultrasound-guided EPI technique was used for the treatment of plantar fasciitis that was refractory to conservative measures.
All patients had undergone physical therapy and anti-inflammatory therapy with no clinical satisfactory results.
In our department,
this procedure is performed by a musculoskeletal radiologist and a Physical Medicine and Rehabilitation physician.
It consist in the ultrasound-guided puncture of the thickest area of the plantar fascia,
corresponding to the area of most pain.
galvanic current is applied.
We usually apply 600-1200 J with 1 mA intensity.
Ultrasound-guided EPI procedure is having a growing interest in sports medicine and in the treatment of tendinopathy.
It is a simple technique and can be a useful therapeutic option for the treatment of refractory to treatment plantar fasciitis.
1 Sànchez-Ibàñez JM,
Ultrasound-Guided EPI® Technique and Eccentric Exercise,
New Treatment for Achilles and Patellar Tendinopathy Focused on the Region-Specific of the Tendon. Orthop Muscular Syst 4: 200.
2 Abat F,
Mecanismos moleculares de reparación mediante la técnica Electrólisis Percutánea Intratisular en la tendinosis rotuliana. Rev Esp Cir Ortop Traumatol.
3 Valera-Garrido F,
Ultrasound-guided percutaneous needle electrolysis in chronic lateral
epicondylitis: short-term and long-term resultsAcupunct Med 2014; 0:1–9.
4 Abat F,