Moron De La Frontera

Researchers are studying the use of noninvasive neuromodulation of the phrenic nerve to treat right shoulder pain in patients who also have hepatobiliary liver and bile duct disorders. This study aims to explore whether the visceral condition related to the liver can cause referred pain in the shoulder by involving the phrenic nerve. The project is based on the idea that some chronic pain may be linked to changes in the nervous system caused by liver-related issues, which might contribute to ongoing shoulder pain. Participants will be randomly assigned to one of two groups. One group will receive the usual physiotherapy treatment at the health center, which includes manual therapy, exercise, and thermotherapy. The other group will receive the same usual physiotherapy treatment plus a 10-minute session of neuromodulation applied to the phrenic nerve at its exit through the front of the neck. This treatment is designed to assess the response of the nerve stimulation for shoulder pain relief. Throughout the study, participants pain and shoulder function will be evaluated before treatment and then at 1 week, 4 weeks, and 12 weeks after treatment begins. Assessments will include a Numeric Pain Rating Scale, algometry pain sensitivity measurement, passive and active shoulder movement measurements, and a Quick Dash questionnaire to assess disability. The study involves double-blind methods and will continue until December 2026. Participants will be monitored closely for changes in pain and function during this period.