Transcutaneous Electrical Nerve Stimulation (TENS), Interferential Current (IFC) and Percutaneous Needle Electrolysis (PNE) in the treatment of sports-related pain: a scoping review with an evidence gap map

This scoping review aimed to synthesize the methodological characteristics of electrical stimulation techniques for managing sports-related pain, summarize their effects on pain intensity, and identify evidence gaps. Following PRISMA-ScR guidelines, a search was conducted on June 27, 2025, across PubMed, Scopus, and Web of Science. Eligible studies were peer-reviewed trials involving competitive athletes (all ages, sexes, and performance tiers) treated with transcutaneous electrical nerve stimulation (TENS), intramuscular electrical stimulation (IMES), or percutaneous needle electrolysis (PNE) for sports-related pain. During screening, we also included trials of related electrical stimulation modalities (e.g., interferential current (IFC), excitomotor neuromuscular electrical stimulation (NMES), and TECAR) when they were explicitly used to treat sports-related pain in competitive athletes. Study designs included randomized controlled trials, crossover trials, and retrospective cohort studies. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Eight studies met inclusion criteria (from 9,087 non-duplicated records). Participants were competitive athletes (Tier 1–4; mean age 21.0 ± 2.9 to 35.2 ± 9.8 years), with 62.5% mixed-sex cohorts. TENS was used in 75% of studies; IFC, Excitomotor, TECAR, and PNE each appeared in one. No eligible studies evaluating IMES in the athletic population were found. Pain reduction (p ≤ 0.05) was reported in 62.5% of studies, with TENS effective in 66.7% (4/6). Combined approaches (e.g., TENS + diaphragm training; PNE + eccentric exercise) showed greater reductions (p ≤ 0.001). Comparators included placebo (37.5%), rest (25%), and exercise (12.5%). Current, limited, and heterogeneous evidence suggests that TENS may reduce pain intensity in athletes, particularly when combined with exercise-based rehabilitation, but overall certainty is low. However, the available evidence on PNE is scarce, and evidence on IMES in athletes is lacking. Standardized protocols, sex-specific analyses, and longitudinal studies are needed to improve clinical applicability and understand long-term effects.