Percutaneous Electrical Nerve Stimulation Compared to Passive Assisted Neurodynamics in Brachial Plexus Neuropathy

Efficacy of Percutaneous Electrical Nerve Stimulation Compared With Passive Assisted Neurodynamics in Brachial Plexus Neuropathy: a Pilot Randomized Controlled Trial.

Brachial plexus neuropathies, specifically of the median, radial, ulnar, suprascapular, axillary and dorsal scapular nerves, can arise when a peripheral nerve trunk or nerve root is subjected to injury, compression, inflammation or ischemia, resulting in reduced physical capabilities of the peripheral nervous system. Although pharmacological treatments provide mild symptomatic relief in the short term, they are not without side effects.

Neurostimulation techniques may be an effective treatment option for peripheral brachial plexus neuropathies. Some of these procedures are transcutaneous electrical nerve stimulation (TENS) or percutaneous electrical nerve stimulation (PENS). Although some case series have documented a positive effect in relation to ultrasound-guided PENS for subjects with subacromial pain syndrome or postsurgical pain, the lack of studies, to our knowledge, analyzing the effects of percutaneous electrical nerve stimulation, in relation to pain and paresthesias in subjects with brachial plexus neuropathy, warrants investigation for this goal.

Inclusion Criteria:

• Subjects with upper limb neural symptomatology between 18 and 60 years of age, presenting two or more of the following conditions:
• Paresthesias in any territory of the shoulder girdle, arm or hand
• Pain at rest in any territory of the upper extremity.
• Pain at rest in any upper extremity territory
• Sensations of electric shock in any territory of the shoulder girdle, arm or hand.
• Allodynia or cutaneous hyperalgesia in any territory of the shoulder girdle, arm or hand.

Exclusion Criteria:

• Less than 2 weeks of evolution
• Fracture in the affected upper extremity
• Suffering from another joint disorder such as osteoarthritis or rheumatic disease
• Suffering from generalized neuropathies due to neuromuscular disease or medication
• Inability to understand instructions or sign informed consent.
• Wearing a pacemaker or any electrical device implanted in the body
• Epilepsy
• Aversion or fear of needles
• Pregnant.