Hip pain in the front of the hip is common and can make daily activities and sports difficult. One frequent cause is femoroacetabular impingement, also known as hip impingement.
This clinical trial is studying whether adding ultrasound-guided percutaneous electrolysis - a minimally invasive physiotherapy technique that uses a fine needle and a small electrical current - to a program of specific exercises works better than doing the exercises alone.
Participants will be randomly assigned to one of two groups:
* One group will receive two sessions of percutaneous electrolysis plus a home exercise program. * The other group will follow the same home exercise program without percutaneous electrolysis.
The study will last five weeks. Researchers will measure pain, hip movement, and hip function at the beginning, after one week, and after four weeks. They will also record any side effects.
The main goal is to find out if adding percutaneous electrolysis helps reduce hip pain and improve function more than exercise alone. This pilot study will help determine if this technique could be a safe and effective non-surgical treatment option for people with pain in the front of the hip.
Anterior hip pain (inguinal region) lasting more than 3 months
Numeric Rating Scale (NRS) pain score ≥ 4/10 during at least one provocative test
Positive result in at least one of the following clinical tests: Straight Leg Raise (SLR), Flexion-Adduction-Internal Rotation (FADIR), or Hip-External Rotation-Flexion-Ceiling (HEC)
Ultrasound findings compatible with pseudofibrotic tissue near the iliopsoas tendon at the anterosuperior acetabular recess
Previous hip surgery
Moderate or severe hip osteoarthritis (diagnosed radiographically)
Neurological pathology affecting the lower limb
Dominant lumbar spine pathology
Parallel
Ultrasound-guided percutaneous needle electrolysis
Other interventionUltrasound-guided percutaneous needle electrolysis will be applied to the iliopsoas region targeting hyperechoic fibrotic tissue near the anterior hip joint. The procedure will be performed using a sterile needle under real-time ultrasound guidance with a long-axis in-plane approach from lateral to medial. Electrical current will be delivered with parameters of 2.5 mA for 3 seconds, with a total of 3 applications per session. Two sessions will be performed, one at baseline and one after 7 days. The intervention will be carried out by a physiotherapist with specific training in invasive techniques.
Therapeutic exercise program
BehavioralParticipants will perform a home-based therapeutic exercise program focused on lumbopelvic stability, hip strength, and controlled mobility. Exercises include glute bridge, bird dog, isometric hip flexion, and controlled hip flexion mobility. The program consists of 3 sets of 10 repetitions per exercise, performed 3 to 4 times per week over a 4-week period. Exercises will be performed within pain-free ranges and adjusted according to individual tolerance. Initial instruction will be provided by a physiotherapist, with follow-up supervision at one week and four weeks.
Mean Numeric Rating Scale (NRS) pain score during provocative hip tests
Average pain intensity measured with the Numeric Rating Scale (NRS 0-10, where 0 = no pain and 10 = worst pain imaginable) during three standardized provocative tests: Straight Leg Raise (SLR), Flexion-Adduction-Internal Rotation (FADIR), and Hip-External Rotation-Flexion-Ceiling (HEC). The mean of the three scores is calculated to obtain a global measure of provoked anterior hip pain.
Numeric Rating Scale (NRS) pain during SLR test
Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Straight Leg Raise (SLR) test.
Numeric Rating Scale (NRS) pain during FADIR test
Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Flexion-Adduction-Internal Rotation (FADIR) test.
Numeric Rating Scale (NRS) pain during HEC test
Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Hip-External Rotation-Flexion-Ceiling (HEC) test.
Hip flexion range of motion to first onset of pain (P1)
Passive hip flexion range of motion measured with a clinical goniometer until the first onset of pain (P1).
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