Effectiveness of ultrasound-guided percutaneous needle electrolysis compared to sham needling in posterolateral lumbar disc herniation: a pilot randomized controlled trial

Study design: A pilot randomized, sham-controlled, single-blinded clinical trial was conducted. Participants: 20 participants with confirmed posterolateral lumbar disc herniations and tibial nerve neuropathic symptoms. Interventions: The treatment group received three sessions of ultrasound-guided percutaneous needle electrolysis (US-guided PNE), while the control group underwent sham needling. Objectives: This study aimed to assess the effectiveness of US-guided PNE in reducing pain and improving muscle strength in individuals with posterolateral lumbar disc herniations compared to sham needling. Materials and Methods: Pain intensity was measured using the Visual Analog Scale (VAS), neuropathic symptoms with the Doleur Neuropatique 4 questionnaire (DN4), and muscle strength via manual muscle testing for hamstrings, triceps surae, and tibialis posterior muscles. Measurements were taken before the first session and four weeks after the third session. Results: The treatment group showed significant reductions in VAS and DN4 scores compared to the control group (p<0.001). Muscle strength improvements were observed in the triceps surae and posterior tibialis muscles for the treatment group (p=0.039 and p=0.049, respectively), while no significant differences were found in the hamstrings (p=0.847). Conclusions: US-guided PNE of the tibial nerve and multifidus muscles is proposed as an effective treatment for lumbar discopathies, offering notable improvements in pain relief and muscle strength over sham needling. These results support the use of US-guided PNE as a viable option for managing symptoms associated with posterolateral lumbar disc herniations.