Combined Use of Diadynamic Currents and Manual Therapy on Myofascial Trigger Points in Patients With Shoulder Impingement Syndrome: A Randomized Controlled Trial

J Manipulative Physiol Ther. Jul-Aug 2018;41(6):475-482. doi: 10.1016/j.jmpt.2017.10.017. Epub 2018 Aug 8.


Objective: The purpose of this study was to evaluate the effect of combined manual therapy (MT) and diadynamic (DD) currents on myofascial trigger points of the upper trapezius muscle in individuals with a diagnosis of unilateral shoulder impingement syndrome.

Methods: A randomized clinical trial was conducted involving 60 individuals with shoulder impingement syndrome who were allocated to the following 3 groups: (1) MT and DD currents (MTDD), (2) MT alone, and (3) DD currents alone. The participants were submitted to 16 treatment sessions over an 8-week period and were evaluated using the Numerical Rating Pain Scale as well as the pain and disability subscales of the Shoulder Pain and Disability Index.

Results: Differences in Numerical Rating Pain Scale scores (secondary outcome) between MTDD and MT groups (mean difference 2.25 points, 95% confidence interval 1.07-3.42) and between MTDD and DD groups (mean difference 2.30 points, 95% confidence interval 1.42-3.17) were clinically relevant. No clinical gains were observed in the comparisons between groups of Shoulder Pain and Disability Index scores.

Conclusion: The combination of MT and DD currents on myofascial trigger points was more effective at reducing pain intensity but not disability than each therapy performed individually for patients with unilateral shoulder impingement syndrome.

Keywords: Myofascial Pain Syndromes; Physical Therapy Modalities; Physical and Rehabilitation Medicine; Shoulder Pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / methods*
  • Neck Muscles / physiopathology
  • Pain Measurement
  • Range of Motion, Articular / physiology
  • Shoulder / physiopathology*
  • Shoulder Impingement Syndrome / therapy*
  • Shoulder Pain / therapy
  • Treatment Outcome
  • Trigger Points*