Effectiveness of Noninvasive Phrenic Nerve Neuromodulation in Subjects With Inflammatory Bowel Disease and Neck Pain: A Randomized Clinical Trial.

OBJECTIVES

This study aimed to analyze whether noninvasive neuromodulation of the phrenic nerve (PN) reduces neck pain in people with inflammatory bowel diseases (IBDs).

MATERIALS AND

METHODS

A randomized controlled trial, with blinded assessors, was conducted with two intervention groups. A total of 68 subjects, aged >18 years, with a disorder of the peridiaphragmatic abdominal viscera and neck pain and who were diagnosed with Crohn's disease or ulcerative colitis, were included. They were randomly divided into two groups; each group included 34 participants (44 women and 24 men). The phrenic neuromodulation group (PNG) underwent neuromodulation treatment on the PN, and the cervicodorsal massage group (CMG) underwent manual therapy. All the subjects received six treatment sessions.

RESULTS

After five weeks, the PNG showed a significant increase in the pressure pain threshold in the left trapezius (mean 4.102 vs 5.431, p = 0.007), the Inflammatory Bowel Disease Questionnaire (IBDQ-32) (mean 139.031 vs 149.594, p = 0.033), the World Health Organization Quality of Life Scale domain 3 (mean 54.094 vs 54.485, p = 0.026), and in cervical mobility, which improved by 13° vs 2° in the CMG. There was a significant reduction in the PNG on the Neck Disability Index (NDI) (mean 15.656 vs 11.875, p ≤ 0.001), the visual analog scale (VAS) (mean 4.781 vs 2.656, p ≤ 0.001), and the Central Sensitization Inventory (CSI) (mean 47.656 vs 40.750, p ≤ 0.001).

CONCLUSIONS

Noninvasive neuromodulation of the PN has been shown to be effective in subjects with neck pain and IBDs, reducing the NDI, VAS, and CSI, and increasing cervical mobility and IBDQ-32.

CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT06288061.