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Invasive Physiotherapy: Main Techniques, Materials, and How to Integrate It into Your Clinic
Invasive physiotherapy has established itself as an advanced solution within physiotherapeutic treatment, standing out for its effectiveness in both chronic and acute musculoskeletal conditions.
This discipline requires specialized training and the use of specific materials. In this article, we will review the main techniques used, the necessary equipment for their application, and how you can safely and effectively integrate invasive physiotherapy into your clinic.
What is Invasive Physiotherapy? Why is it so important?
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Invasive physiotherapy is a set of therapeutic techniques that use needles or other instruments that pierce the skin to treat deep musculoskeletal injuries, guided by anatomical knowledge and, in many cases, by ultrasound.
Unlike conservative techniques, these interventions allow direct action on structures such as trigger points, tendons, ligaments or peripheral nerves, improving clinical outcomes and accelerating patient recovery.
This discipline is on the rise, especially in clinics that bet on advanced technology and more resolute treatments.
Differences Between Invasive and Conventional Physiotherapy
Conventional physiotherapy focuses on non-invasive techniques such as exercises, massages, and electrotherapy to treat pain and musculoskeletal injuries. In contrast, invasive physiotherapy uses methods that require the insertion of needles or devices into the body, such as dry needling or electroacupuncture.
The main difference is that invasive physiotherapy aims to treat more specific or chronic conditions through a more direct intervention, while conventional therapy relies on less intrusive and generally preventive or rehabilitative therapies.
Which Pathologies Benefit Most from Invasive Physiotherapy?
Invasive physiotherapy techniques are especially useful for treating chronic musculoskeletal conditions or those difficult to treat with conventional methods. Some of the conditions that benefit most from these techniques include:
- Myofascial pain syndrome: Characterized by trigger points in the muscles that cause referred pain, dry needling (an invasive technique) is very effective in relieving this type of pain.
- Chronic tendinopathies: Injuries to the tendons, such as tendinopathies or tendinosis—especially in areas like the elbow (epicondylalgia), shoulder (rotator cuff tendinopathies), or heel (plantar fasciopathy)—can respond well to techniques like dry needling or invasive electrotherapy treatments such as electrolysis (APS-e4).
- Chronic low back pain: Persistent lumbar pain can benefit from invasive interventions such as dry needling.
- Cervicalgia: Chronic neck pain can be treated with invasive techniques such as dry needling to release muscular tension points.
- Muscle contractures and spasms: Persistent contractures can be effectively treated through invasive techniques that act directly on the affected tissue.
- Sports injuries: Some complex muscle and joint injuries in athletes, such as muscle tears or partial tendon ruptures, can benefit from invasive physiotherapy to accelerate recovery.
Which Benefits Can It Bring to Your Clinic?
Implementing invasive physiotherapy in your health center allows you to:
✔ Reduce the number of sessions per patient
✔ Improve clinical effectiveness
✔ Offer differentiated treatments
✔ Justify higher fees
✔ Expand your patient portfolio (athletes, chronic pain, postoperative)
Invasive physiotherapy is by no means a stand-alone treatment, but rather an additional tool that can be combined with conventional techniques to enhance results.
Main Techniques and Necessary Equipment
Below is a breakdown of the most commonly used techniques today in professional settings for invasive physiotherapy, including their basis, applications, and recommended products.
1. Dry Needling
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Definition:
A technique that uses a solid needle (without injecting substances) to inactivate myofascial trigger points responsible for referred pain or muscle dysfunction. You can find more information in this Agupunt article on dry needling.
Clinical basis:
Controlled insertion triggers a local twitch response (LTR) and activates neuromodulatory and circulatory mechanisms that reduce pain.
Most common indications:
- Myofascial syndrome
- Muscle contractures (this is the same as Myofascial pain syndrome, but said in a more colloquial way).
- Chronic tendinopathies
Necessary products:
- Sterile dry needling needles (different gauges)
- Gloves, chlorhexidine, sharps containers
2. Therapeutic Percutaneous Electrolysis
Definition:
Application of galvanic current through a needle inserted into injured soft tissue (tendon, fascia, etc.) to induce a controlled inflammatory process that regenerates degenerated tissue.
Clinical basis:
Acts via electrolytic decomposition and activation of cellular repair mechanisms.
Most common indications:
- Achilles or patellar tendinopathy
- Plantar fasciitis
Necessary products:
- Electrolysis device (with screen or portable)
- Adhesive electrodes
- Conductive needles
Recommended device: APS-e4
The APS-e4 is an advanced device specially designed for therapeutic percutaneous electrolysis.. This equipment allows controlled application of galvanic current, facilitating the regeneration of degenerated tissues and offering an effective solution for conditions such as chronic tendinopathies.
3. Percutaneous Neuromodulation (PNM)
Definition:
Electrical stimulation of peripheral nerves through ultrasound-guided needles, aimed at modulating pain and improving neuromuscular function.
Clinical basis:
Selective activation of efferent/afferent pathways that restore the balance of the peripheral nervous system.
Most common indications:
- Neuropathic pain
- Radiculopathies
- Facial paralysis, piriformis syndrome
Necessary products:
- NMP device (The APS-e4 can also be used)
- Clamp-type cables and electrodes
- Conductive needles
4. Electroacupuncture
Definition:
A technique derived from traditional acupuncture, in which electrical current is applied to already inserted needles to enhance their analgesic or neurofunctional effect.
Clinical basis:
Activates endorphin release, improves muscle recruitment, and modulates nerve transmission.
Most common indications:
- Chronic pain
- Spasticity
- Post-injury motor control
Necessary products:
- TENS or EMS current generator (electrostimulation devices) (APS can also be used)
- Clamp-type cables for needles
- Acupuncture needles resistant to current
Final Thoughts from Agupunt
Invasive physiotherapy has become a powerful tool in the rehabilitation of various musculoskeletal pathologies, offering effective solutions when conventional treatments fail to deliver the desired results.
Techniques such as dry needling, percutaneous electrolysis, dry electroacupuncture, and neuromodulation have proven to be highly effective in treating chronic pain, sports injuries, and persistent muscular conditions.. Integrating these techniques into your clinic will not only allow you to offer cutting-edge treatments but also improve the quality and speed of your patients’ recovery.
The implementation of these advanced techniques can differentiate your clinic in the market, justify higher fees, and expand your patient base. Without a doubt, invasive physiotherapy is an investment that can transform your center’s therapeutic approach and make a significant difference in the health and well-being of your patients.