OBJECTIVES: To compare the effects of spinal thrust-manipulation and electrical dry needling (TMEDN-group) to nonthrust peripheral joint/soft-tissue mobilization, exercise and interferential current (NTMEX-group) on pain and disability in patients with subacromial pain syndrome (SAPS). DESIGN: Randomized, single-blinded, multi-center, parallel-group trial. METHODS: Patients with SAPS were randomized into the TMEDN group (n = 73) or the NTMEX group (n = 72). Primary outcomes included the shoulder pain and disability index (SPADI) and the numeric pain rating scale (NPRS). Secondary outcomes included Global Rating of Change (GROC) and medication intake. The treatment period was 6 weeks; with follow-up at 2 weeks, 4 weeks, and 3 months. RESULTS: At 3 months, the TMEDN group experienced greater reductions in shoulder pain and disability (p < 0.001) compared to the NTMEX group. Effect sizes were large in favor of the TMEDN group. At 3 months, a greater proportion of patients within the TMEDN group achieved a successful outcome (GROC >= +5) and stopped taking medication (p < 0.001). CONCLUSION: Cervicothoracic and upper rib thrust-manipulation combined with electrical dry needling resulted in greater reductions in pain, disability and medication intake than nonthrust peripheral joint/soft-tissue mobilization, exercise and interferential current in patients with SAPS. These effects were maintained at 3 months.

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