{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:37:45Z","timestamp":1792841865314,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>Shoulder pain is highly prevalent and may persist despite conservative care, leading to functional limitation and substantial healthcare burden. Percutaneous peripheral nerve stimulation (PNS) has emerged as a targeted neuromodulation strategy; however, randomized evidence remains heterogeneous across stimulation parameters and clinical presentations. This systematic review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251247712). PubMed, Scopus, Embase, and Web of Science were searched (December 2015\u2013December 2025; English language). Randomized controlled trials (RCTs) evaluating percutaneous PNS-related interventions for postoperative shoulder pain, chronic shoulder pain, supraspinatus tendinopathy, upper trapezius myofascial pain, and cervical-related shoulder pain were included. The search identified 2189 records; after removal of 723 duplicates, 1466 titles and abstracts were screened and 54 full texts assessed. Ten RCTs met eligibility criteria. Postoperative trials demonstrated clinically meaningful pain reductions and opioid-sparing effects with ultrasound-guided brachial plexus PNS compared with sham stimulation. In supraspinatus tendinopathy, multimodal programs integrating PNS with eccentric exercise and percutaneous electrolysis yielded superior improvements in pain and disability compared with conventional rehabilitation. For upper trapezius myofascial pain, intramuscular and percutaneous stimulation protocols produced short-term improvements in pain and mechanical sensitivity. Cervical neuromuscular stimulation trials also demonstrated significant benefits in pain and range of motion. Overall risk of bias was moderate to high, with the majority of trials rated as low risk and the remainder as having some concerns. Current RCT evidence supports percutaneous PNS as a safe and clinically relevant intervention for shoulder pain, particularly in postoperative analgesia and chronic tendinopathy when integrated into rehabilitation programs. However, substantial variability in stimulation dosimetry highlights the need for protocol standardization in future trials.<\/jats:p>","DOI":"10.1177\/10538127261456343","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:01:45Z","timestamp":1780315305000},"page":"1819-1829","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous peripheral nerve stimulation for shoulder pain: A systematic review of randomized controlled trials"],"prefix":"10.1177","volume":"39","author":[{"given":"Gabrielly","family":"Santos Pereira","sequence":"first","affiliation":[{"name":"Neuropsychobiology and Motor Behavior Laboratory, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo - USP, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilton \u00c1lvaro","family":"Amorim Mazuy","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Nevion, Primavera do Leste, MT, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivando Luiz","family":"Ara\u00fajo J\u00fanior","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Nevion, Primavera do Leste, MT, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-5910","authenticated-orcid":false,"given":"Marcelo","family":"Louren\u00e7o da Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-023-01976-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40674-021-00184-z"},{"key":"e_1_3_3_4_2","article-title":"Shoulder pain","volume":"2010","author":"Murphy RJ","year":"2010","unstructured":"Murphy RJ, Carr AJ. Shoulder pain. BMJ Clin Evid 2010; 2010: 1107. 2010\/01\/01.","journal-title":"BMJ Clin Evid"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000001354"},{"key":"e_1_3_3_6_2","first-page":"11","article-title":"Shoulder conditions: rotator cuff injuries and bursitis","volume":"491","author":"VanBaak K","year":"2020","unstructured":"VanBaak K, Aerni G. Shoulder conditions: rotator cuff injuries and bursitis. FP Essent 2020; 491: 11\u201316. 2020\/04\/22.","journal-title":"FP Essent"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.11.002"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X20666221012112725"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2022-0070"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12040771"},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","unstructured":"Valenzuela-Rios C Arias-Bur\u00eda JL Rodr\u00edguez-Jim\u00e9nez J et al. Effects of adding four sessions of ultrasound-guided percutaneous electrical nerve stimulation to an exercise program in patients with shoulder pain: a randomized controlled trial. Musculoskelet Sci Pract 2024; 13: 3171.","DOI":"10.3390\/jcm13113171"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24054540"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-024-00659-6"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2025-107160"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/17581869.2024.2352398"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-021-00298-1"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2024.11.005"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2018-100121"},{"key":"e_1_3_3_19_2","article-title":"Ultrasound-Guided percutaneous peripheral nerve stimulation: a pragmatic effectiveness trial of a nonpharmacologic alternative for the treatment of postoperative pain","volume":"21","author":"Ilfeld BM","year":"2020","unstructured":"Ilfeld BM, Gelfand H, Dhanjal S, et al. Ultrasound-Guided percutaneous peripheral nerve stimulation: a pragmatic effectiveness trial of a nonpharmacologic alternative for the treatment of postoperative pain. Pain Med (Malden, Mass) 2020; 21: S53\u2013s61. 2020\/12\/15.","journal-title":"Pain Med (Malden, Mass)"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/jfmk10030295"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.18502\/jmr.v17i1.11290"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1590\/bjpt-rbf.2014.0176"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3344\/kjp.24332"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011080"},{"key":"e_1_3_3_25_2","first-page":"35","article-title":"Effects of percutaneous neuromuscular electrical stimulation for neck pain in patients with cervical spondylosis","volume":"27","author":"Miao Q","year":"2021","unstructured":"Miao Q, Jiang HJ, Zhan YL. Effects of percutaneous neuromuscular electrical stimulation for neck pain in patients with cervical spondylosis. Altern Ther Health Med 2021; 27: 35\u201339. 2020\/02\/24.","journal-title":"Altern Ther Health Med"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.11.004"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001413"},{"key":"e_1_3_3_29_2","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann TC","year":"2014","unstructured":"Hoffmann TC, Glasziou PP, Boutron I, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ (Clinical Research ed) 2014; 348: g1687. 2014\/03\/13.","journal-title":"BMJ (Clinical Research ed)"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1054\/jpai.2003.434"},{"key":"e_1_3_3_31_2","article-title":"Ultrasound-guided regional anesthesia and patient safety: an evidence-based analysis","volume":"35","author":"Neal JM","year":"2010","unstructured":"Neal JM. Ultrasound-guided regional anesthesia and patient safety: an evidence-based analysis. Reg Anesth Pain Med 2010; 35: S59\u2013S67. 2010\/03\/23.","journal-title":"Reg Anesth Pain Med"}],"container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261456343","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10538127261456343","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261456343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:07:41Z","timestamp":1792840061000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10538127261456343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/10538127261456343"],"URL":"https:\/\/doi.org\/10.1177\/10538127261456343","relation":{},"ISSN":["1053-8127","1878-6324"],"issn-type":[{"value":"1053-8127","type":"print"},{"value":"1878-6324","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}