Effectiveness of Dry Needling Versus Percutaneous Electrolysis in Achilles Tendinopathy: A Randomized Clinical Trial

Introduction: Achilles tendinopathy (AT) is characterized by pain, inflammation, and functional limitations. It is also the most common cause of pain located at the back of the calcaneus. The Achilles tendon is among the most vulnerable tendons in the lower limb, and its pathology is one of the most common overuse injuries. Moreover, it is not an injury exclusive to athletes, as 65% of diagnosed Achilles tendinopathies are not related to sport. Methods: Randomized, single-blind clinical trial with 60 patients, 30 in each group. All study participants were previously diagnosed with insertional AT, mid-portion tendinopathy, or both and were referred by an orthopedic surgeon. The short- and medium-term results of treatment with dry needling (DN) application to the gastrocnemius muscle trigger points (MTrPs) versus ultrasound-guided percutaneous electrolysis (PE) application to the Achilles tendon were observed in terms of pain intensity, pressure pain threshold, ankle dorsiflexion range of motion under load, quality of life, and ankle and foot function in patients with previously diagnosed AT. Results: The visual analogue scale revealed that the time effect was statistically significant. Similarly, AT algometry revealed that the time effect was statistically significant, indicating that the pressure pain threshold assessed by algometry changed significantly over the course of the study. Moreover, quality of life and functionality showed statistically significant improvements from the third week of the study, whereas range of motion remained unchanged. Conclusion: Ultrasound-guided PE applied to the Achilles tendon is more effective than DN applied to the MTrPs of the gastrocnemius muscle in reducing pain intensity and improving quality of life and ankle and foot function in the short and medium term in patients with AT.