The Effects of Iontophoresis in the Treatment of Musculoskeletal Disorders - A Systematic Review and Meta-Analysis

This systematic review and meta-analysis is focusing on the evidences related to iontophoresis used to enhance the topical drug delivery through the skin in the treatment of inflammatory dysfunctions, acute soft tissue injuries and pain. A literature search in the databases, MEDLINE (PubMed), Pedro, and the Cochrane Database of Systematic Reviews was conducted. The methodological quality of the obtained studies was independently rated by two reviewers. Data were pooled from those studies in which the effect of iontophoresis treatment on pain was compared with a control or sham (placebo) intervention. Twenty four experimental studies evaluating the effectiveness of iontophoretic treatment were included. Based on comparable statistical outcome for pain, the results of ten studies could be pooled for metaanalysis. Although several clinical studies claimed an advanced healing process after iontophoresis, controversy on the healing efficacy of iontophoresis remains. The overall summary estimate of the pooled post treatment values for pain was -0.672 [95%CI: -0.970 to -0.375] favouring iontophoresis treatment (p < 0.0001). The observed trend between studies heterogeneity for the post treatment pain values was low to moderate (I2 = 39.9%; p = 0.092). The results of the metaanalysis indicate quantitative evidence that iontophoresis is effective in the treatment of pain, however, the lack of solid research design in studies on iontophoresis makes it difficult to ensure that the improvements observed can be explained by the iontophoresis technique in se.