What is EPI and when is it used? A patient guide
By Oriol Martínez Picas, registered physiotherapist (Col. 10224) · Published
EPI is an invasive physiotherapy technique that applies a low-intensity galvanic current directly to a tendon or other injured tissue, guided by ultrasound, to support its repair.
How it works
With a very fine needle and the ultrasound scanner, we reach the exact spot of the damaged tissue. The current creates a controlled local reaction that, as far as we currently know, helps the body restart the repair process in tissue that had stalled.
Ultrasound is key: it lets us see the tendon, know where to insert the needle and avoid vessels and nerves.
Which injuries it is used for
- Tendinopathies that do not improve with rest and exercise: patellar, Achilles, tennis elbow or shoulder tendon.
- Stubborn plantar fasciitis.
- Some muscle or tendon problems in athletes.
It is not a first option for everyone: many injuries improve with well-dosed exercise alone. We decide this at the first visit.
What you will feel
A tolerable discomfort for a few seconds. In the following 24–48 hours it is common to feel something like muscle soreness in the area.
How many sessions you need
It depends on the injury and how long it has been there. As a guide, 2 to 6 sessions spaced days or weeks apart, always combined with progressive exercise. EPI does not work alone: it is one part of the rehabilitation plan.
When it is not done
- Pregnancy.
- Pacemakers or other implanted electronic devices.
- Active infection in the area or significant clotting disorders.
- Strong fear of needles: we talk it through and look for alternatives.
What the evidence says
EPI is used more and more and studies show promising results, but the evidence is still limited. That is why I explain it honestly at the visit and do not suggest it if it makes no sense in your case.