Ultrasound-guided Percutaneous Neuromodulation Versus Dry Needling in Shoulder Pain Treatment

Efficacy of Ultrasound-guided Percutaneous Neuromodulation Versus Ultrasound-guided Dry Needling of the Suprascapular Nerve in Shoulder Pain

Background: nonspecific shoulder pain is very common and the symptoms can persist for 6 to 12 months in half of patients. Ultrasound-guided Percutaneous Neuromodulation (US-guided PNM) is an intervention based in an electrical stimulation of a peripheral nerve through a needle located close to the target nerve by the use of an ultrasound guidance.

Objectives: the primary aim is to determine changes in strength after US-guided PNM or Ultrasound-guided Dry Needling (US-guided DN) intervention in the Suprascapular Nerve (SN) as well as its effectiveness in changes of muscle function, pain and disability.

Methods: randomised clinical trial (ratio 1:1), single-blind (examiners), parallel, with assessment of third parties. 62 adult participants with unilateral mechanical chronic nonspecific shoulder pain with at least 3-month evolution and shoulder muscle weakness will randomised to one of two procedures: US-guided PNM or US-guided DN. It will be assessed muscle strength, muscle function, pain and disability before, just after, a week and a month after the intervention.

Shoulder pain is the third reason for medical consultation in the world. Many treatment techniques have been proposed. Neuromodulation techniques through the application of an analgesic electric current using a needle as an electrode, are increasingly used in the treatment of pain.

In this study, the investigators will compare whether the application of a neuromodulation technique is more effective than applying the dry needling technique in isolation.

Inclusion Criteria:

• Chronic mechanical unilateral shoulder pain of non-specific origin of at least 3 months of evolution
• Weakness in the abduction force and / or external rotation of the shoulder.

Exclusion Criteria:

• Previous shoulder surgery.
• Previous history of shoulder dislocation
• Whiplash.
• Cervical radiculopathy.
• Total rupture of the rotator cuff.
• Adhesive capsulitis.
• Fibromyalgia diagnosis.
• Diabetes.
• Needle phobia or some contraindication for dry needling (anticoagulants or psychiatric disorders).
• Bilateral shoulder pain.
• Pregnancy or having received a dry puncture in the shoulder region in the last 6 months