Moron De La Frontera

Researchers are studying the effectiveness of noninvasive neuromodulation of the phrenic nerve to treat right shoulder pain in patients who also have hepatobiliary (liver and bile duct) disorders. These patients often experience chronic pain and fatigue, which may involve changes in the nervous system leading to increased pain sensitivity. The study explores the theory that pain from liver-related conditions can be referred to the shoulder area due to shared nerve pathways. Participants will be divided into groups where one group receives the usual physical therapy treatment including manual therapy, exercise, and thermotherapy, while the other group receives the same physical therapy plus 10 minutes of phrenic nerve neuromodulation applied at the neck area. This neuromodulation technique aims to influence nerve signals and potentially reduce pain. During the study, researchers will assess participants' shoulder pain using a Numeric Pain Rating Scale before treatment, and then at 1 week, 4 weeks, and 12 weeks afterward. Participants will be monitored for changes in pain and the possible visceral cause of their pain. Safety and response to the treatments will be carefully followed throughout the study.