EPTE is a treatment for tendon problems. More and more physiotherapists are using this treatment for long-standing tendon problems. The aim of EPTE is to trigger an inflammatory reaction exactly at the right spot in the tendon. This restarts the healing of tendon tissue.

What are chronic tendon problems/tendinopathies?

Chronic tendon problems, also called tendinopathies, concern tendons whose quality has decreased. For example due to ageing, overuse, inactivity, medication use or rheumatic conditions. When quality has decreased and the load on the tendons is not reduced, pain symptoms develop. If this balance is disturbed for a long time, this turns into chronic tendon problems.

Long-standing tendon problems are a major issue for patients and therapists. Recovery and treatment often take a long time and do not always produce a good result. New treatment options such as EPTE are therefore very welcome for many patients.

Why do tendons heal so poorly?

Tendons are less well supplied with blood. Blood provides the supply of oxygen and building blocks and the removal of waste products. In tendinopathy there are tendon fibres of poor quality, but there are also still fibres of good quality. With exercises/training the healthy fibres become stronger. But training has little effect on the poor tendon fibres. As a result, part of the tendon becomes stronger, but not the entire tendon.

What does EPTE treatment look like?

A small needle is inserted into the tendon (percutaneous). 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 placed exactly in the area with the poor tendon fibres. The needle is energised for 80-110 seconds. This can feel unpleasant but does not hurt.

What is the effect of 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 healing processes occur in the tendon:

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

EPTE therefore creates the right conditions for recovery.

What is the treatment besides EPTE?

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

Is there scientific evidence for EPTE?

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

For which conditions does EPTE work?

EPTE only works 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 tendon, part of the rotator cuff).
Patellar tendon (for example in a jumper's knee).
Forearm tendon (tennis elbow).

EPTE