Percutaneous peripheral nerve stimulation for shoulder pain: A systematic review of randomized controlled trials.
Gabrielly Santos Pereira, Nilton Álvaro Amorim Mazuy, Ivando Luiz Araújo Júnior et al.
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In 30 seconds
This PRISMA-guided systematic review assessed randomized controlled trials of percutaneous peripheral nerve stimulation (PNS)-related interventions for postoperative and other shoulder pain presentations. Ten RCTs met eligibility criteria. Postoperative studies reported clinically meaningful pain reductions and opioid-sparing effects with ultrasound-guided brachial plexus PNS versus sham. Trials in tendinopathy and other pain presentations also reported improvements in pain, disability, mechanical sensitivity, or range of motion, although interventions and populations varied. The review judged overall risk of bias moderate to high and highlighted substantial variation in stimulation parameters. No pooled effect estimate was reported in the abstract.
Key findings
- Ten randomized controlled trials met the review’s eligibility criteria.
- Postoperative trials reported clinically meaningful pain reductions and opioid-sparing effects with ultrasound-guided brachial plexus PNS compared with sham stimulation.
- For supraspinatus tendinopathy, programs combining PNS with eccentric exercise and percutaneous electrolysis improved pain and disability more than conventional rehabilitation.
- Across trials, risk of bias was moderate to high, and stimulation dosimetry varied substantially.
Why it matters
The review suggests that percutaneous PNS may have a role across several shoulder pain presentations, with the clearest reported signal in postoperative analgesia and rehabilitation-integrated tendinopathy care. However, heterogeneous protocols and moderate-to-high risk of bias limit confidence in comparing results or identifying an optimal approach. Standardized stimulation parameters and stronger trials are needed to clarify the consistency and clinical value of these findings.
What to keep in mind
The included trials varied in clinical presentation and stimulation dosimetry, and overall risk of bias was moderate to high. The abstract reports no pooled effect estimate.