EPTE is a treatment for tendon problems. More and more physical therapists are using this treatment for long-standing tendon problems. The goal of EPTE is to trigger an inflammatory response exactly at the right spot in the tendon. This promotes healing of the tendon tissue.

What are chronic tendon problems/tendinopathies?

Chronic tendon problems, also called tendinopathies, involve tendons whose quality has deteriorated. For example due to aging, overuse, inactivity, medication use, or rheumatic conditions. When the quality has decreased and the load on the tendons is not reduced, pain occurs. If this imbalance remains disturbed for a long time, it develops into chronic tendon problems.

Long-lasting tendon symptoms are a major problem for patients and practitioners. Recovery and treatment often take a long time and do not always produce good results. That is why new treatment methods such as EPTE are more than welcome for many patients.

Why do tendons heal so poorly?

Tendons have a poorer blood supply. Blood supplies oxygen and building blocks and removes waste products. In tendinopathy there are tendon fibers of poor quality, but there are also still fibers of good quality. With exercises/training the healthy fibers become stronger. But training has little effect on the poor-quality tendon fibers. As a result, part of the tendon does become stronger, but not the entire tendon.

What does an EPTE treatment look like?

A small needle is inserted into the tendon (percutaneously). This needle delivers an electrical stimulus to the tendon. This stimulus provides the therapeutic effect. By using ultrasound, the problem area in the tendon and the location of the needle can be determined precisely. The needle can therefore be inserted exactly into the area with the poor-quality tendon fibers. The needle is energized for 80-110 seconds. This can feel unpleasant but does not hurt.

What is the effect of an EPTE treatment?

Pain often decreases within a few treatments or even disappears completely. This pain reduction is often most important for patients. In addition, the following recovery processes occur in the tendon:

In tendinopathy the acidity (pH) of the tendon tissue has changed. The current changes the acidity in the tendons.
Blood flow improves. This leads to the supply of new nutrients and building blocks and the removal of waste products.
The tendon cells are stimulated to build strong tendon tissue.

EPTE therefore creates the right conditions for recovery.

What is the treatment in addition to EPTE?

As stated, all conditions for the recovery of healthy tendon tissue are created. The normal recovery process then follows. This remains very important. Due to pain reduction, people often think they are immediately cured. But a tendon that has been painful for months and has been loaded less is not suddenly better. EPTE can allow all the tendon cells to recover, but they must be strengthened again with advice and a targeted exercise program.

Is there scientific evidence for EPTE?

Yes, but not much yet. Because EPTE is a fairly new treatment method, there has been little good scientific research so far. This should come over time.

For which conditions does EPTE work?

EPTE works only for tendinopathies. So not for bursitis, problems in the joint capsule, or calcium deposits in the tendons. The most scientific evidence exists for the following tendons:

Achilles tendon.
Plantar fasciitis (plantar fascia under the foot).
Supraspinatus tendon (shoulder muscle tendon, part of the rotator cuff).
Patellar tendon (for example in a jumper's knee).
Forearm tendon (tennis elbow).

EPTE