Ultrasound-Guided Percutaneous Electrical Nerve Stimulation (PENS) as an Adjunct to a Multimodal Physical Therapy Program for Postoperative Shoulder Pain: A Randomized Clinical Trial.

BACKGROUND/

objectivesArthroscopic shoulder surgery is associated with postoperative pain and loss of function. Percutaneous electrical nerve stimulation (PENS) may serve as an effective adjunct to postoperative rehabilitation. This randomized clinical trial examined whether adding ultrasound-guided PENS to a multimodal rehabilitation program improves pain, disability, pressure pain sensitivity, shoulder range of motion, and muscle strength in individuals with postoperative pain following shoulder arthroscopy.

methodsA randomized, parallel-group clinical trial (registry: NCT06331871) was conducted. Seventy patients who had undergone shoulder arthroscopy were randomized to receive manual therapy/exercise alone (

resultsPatients receiving PENS showed greater improvements in shoulder pain (F

conclusionsAdding ultrasound-guided PENS targeting the suprascapular and axillary nerves to a multimodal physical therapy program resulted in greater improvements in pain, disability, and shoulder-specific function, with limited additional benefits for some measures of strength and range of motion, compared with physical therapy alone, in individuals with postoperative shoulder pain. However, many of the lower-bound estimates of the 95% confidence interval did not surpass the minimal clinically important difference. Therefore, the clinical relevance of the results should be considered with caution.