A novel approach in the treatment of acute whiplash syndrome: Ultrasound-guided needle percutaneous electrolysis. A randomized controlled trial

Abstract

Introduction: Whiplash associated disorders are currently a common musculoskeletal problem. Besides the high incidence in Western countries, the costs derived from prolonged treatment and medico-legal compensation, make this entity a challenging problem for clinicians and insurance companies. To date, no conservative treatment has shown clear superiority in the management of acute cases. Hypothesis: Percutaneous needle electrolysis (PNE) is an effective approach for the treatment of Quebec type II acute whiplash syndrome (AWS). PNE consists in the application of brief galvanic currents into a damaged structure, producing a local controlled inflammatory response, with subsequent tissular healing enhancement. Materials and methods: One hundred AWS patients were randomized into (A) standard physiotherapy intervention for AWS and (B) a standardized PNE protocol for AWS. Both groups were assessed for treatment outcome at the 5th week mark. Results: Both groups showed a statistically significant improvement according to the Northwick Park Neck Questionnaire, visual analogic scale and pressure pain threshold. The improvement was similar in both groups, except for the pain pressure threshold, with a 56.6% reduction vs. 44.4% reduction in favour of the PNE group (P = 0.035). In addition, the physio group consumed a mean treatment time of 20 hours, while the PNE intervention averaged less than one hour in total. Discussion: PNE can be considered as an effective treatment option for AWS. Importantly, the technique is highly cost-effective, with limited equipment required and a notable treatment time reduction, compared to more comprehensive physiotherapy protocols. Type of study Randomized controlled trial. Level of proof 1b.