Tedeschi Roberto, Giorgi Federica, Donati Danilo
Independent Researcher, 40100 Bologna, Italy.
Pediatric Physical Medicine and Rehabilitation Unit, IRCCS Institute of Neurological Sciences, 40139 Bologna, Italy.
Brain Sci. 2025 May 28;15(6):584. doi: 10.3390/brainsci15060584.
Chronic shoulder pain is a prevalent musculoskeletal disorder often associated with central sensitisation, which limits the effectiveness of conventional therapies. Transcranial direct current stimulation (tDCS) has emerged as a non-invasive neuromodulatory intervention to modulate cortical excitability and potentially improve pain and functional outcomes.
This scoping review followed the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search was conducted across MEDLINE, CENTRAL, Scopus, PEDro, and Web of Science to identify studies evaluating the effects of tDCS on pain and function in adults with rotator cuff disorders, myofascial pain syndrome (MPS), or subacromial pain syndrome (SAPS). Data were extracted and synthesised qualitatively.
Four studies met the inclusion criteria. tDCS demonstrated variable efficacy: some trials reported no additional benefit when used alongside corticosteroid injections or sensorimotor training (e.g., SAPS and rotator cuff tendinopathy), while others showed enhanced pain reduction and functional gains, particularly in MPS. Targeting the dorsolateral prefrontal cortex (DLPFC) appeared more effective than stimulating the primary motor cortex (M1) in modulating pain. Functional improvements were generally observed, though not consistently superior to sham interventions.
Preliminary evidence suggests that tDCS may represent a promising adjunctive treatment for chronic shoulder pain, particularly in MPS. However, due to the limited number of studies and heterogeneity in methods, conclusions should be interpreted with caution. However, heterogeneity in study protocols, stimulation targets, and patient populations limits conclusive recommendations. Standardised protocols and larger trials are needed to determine the optimal application of tDCS in clinical shoulder pain management.
慢性肩痛是一种常见的肌肉骨骼疾病，常与中枢敏化相关，这限制了传统疗法的有效性。经颅直流电刺激（tDCS）已成为一种非侵入性神经调节干预措施，可调节皮层兴奋性并可能改善疼痛和功能结局。
本范围综述遵循乔安娜·布里格斯研究所（JBI）框架和PRISMA-ScR指南。在MEDLINE、CENTRAL、Scopus、PEDro和科学网进行了系统检索，以识别评估tDCS对患有肩袖疾病、肌筋膜疼痛综合征（MPS）或肩峰下疼痛综合征（SAPS）的成年人疼痛和功能影响的研究。对数据进行定性提取和综合。
四项研究符合纳入标准。tDCS显示出不同的疗效：一些试验报告称，与皮质类固醇注射或感觉运动训练同时使用时没有额外益处（如SAPS和肩袖肌腱病），而其他试验则显示疼痛减轻和功能改善更为明显，尤其是在MPS中。在调节疼痛方面，靶向背外侧前额叶皮层（DLPFC）似乎比刺激初级运动皮层（Ml）更有效。虽然通常观察到功能改善，但并不总是优于假干预。
初步证据表明，tDCS可能是慢性肩痛的一种有前景的辅助治疗方法，尤其是在MPS中。然而，由于研究数量有限且方法存在异质性，结论应谨慎解释。然而，研究方案、刺激靶点和患者群体的异质性限制了确定性推荐。需要标准化方案和更大规模的试验来确定tDCS在临床肩痛管理中的最佳应用。
