The Impact of Dry Needling with Electrical Stimulation on Pain and Disability in Patients with Musculoskeletal Shoulder Pain: A Systematic Review with Meta-Analysis

Objective(s): To investigate the effectiveness and safety of dry needling with electrical stimulation (DNES) in patients with musculoskeletal shoulder pain to improve patient outcomes.

Data Sources: A systematic review with meta-analysis was conducted using PubMed, MEDLINE, CINAHL, and Web of Science to March 10th, 2023, from database inception.

Study Selection: A total of 144 articles were found on initial search using search terms ("dry needling" OR "acupuncture") AND (electric OR electrical) AND ("shoulder pain" OR "rotator cuff" OR "subacromial"). Inclusion criteria was studies involving DNES, patient outcomes, and randomized controlled trials. Exclusion criteria was no interventions with DNES in the study and lower level of evidence studies. Control interventions compared to DNES included exercise, manual therapy, dry needling, and interferential current.

Data Extraction: Data extraction and collection was completed by multiple authors. Data collection included method of DNES, pain on a 0-10 scale, disability via the Shoulder Pain and Disability Index (SPADI), follow-up times, and adverse effects.

Data Synthesis: A total of 5 randomized controlled trials were analyzed from 144 articles retrieved on initial search. Included patients (n=342) had an average age of 48.75 ± 5.92 years with an average follow-up time of 3.40 ± 1.42 months with 184 patients receiving DNES. For pain outcomes (n=321 total patients), DNES improved pain by 1.40/10 points with no significant difference as compared to controls (p=0.203). For disability outcomes (n=233 total patients), DNES improved disability by 10.00/100 points with no significant difference as compared to controls (p=0.282). No serious adverse effects were reported for patients treated with DNES or control interventions.

Conclusions: DNES may provide clinically significant improvements in pain and disability in patients with shoulder pain. However, DNES does not provide statistically significant improvements in pain or disability as compared to other interventions. DNES appears to be a safe intervention for musculoskeletal shoulder pain. This study represents the first systematic review and meta-analysis on the effectiveness of DNES for patients with shoulder pain.

Author(s) Disclosures: The authors have no relevant disclosures to make known.