Comparative Study of Pain Relief in Two Non-Pharmacological Treatments in Patients with Partial Rotator Cuff Tears: A Randomized Trial.

Abstract

BackgroundPain induction is the primary characteristic of a rotator cuff tear while muscle weakness appears as a secondary feature, leading to further disability.ObjectivesThe study aimed to determine the effectiveness of physiotherapeutic interventions through transcutaneous electrical nerve stimulation (TENS) or microcurrent electrical nerve stimulation (MENS) in conjunction with kinesiotherapy in patients with partial thickness rotator cuff tear.MethodsThis was a blinded randomized prospective study. The study recruited 42 outpatients with partial rotator cuff tear under conservative treatment selected from the 401 General Military Hospital of Athens and the University General Hospital ‘Attikon’ during 2015 - 2017. Patients were assessed for pain and disability using the SPADI (shoulder pain and disability index), a numerical rating scale (NRS) for pain, and the EuroQoL-5 questionnaire for the evaluation of the quality of life. The first group received TENS and kinesiotherapy while the second group received MENS and kinesiotherapy. Three measurements were recorded. The first assessment was performed during the initial patient visit; the second after completion of the physiotherapeutic sessions, and the third one three months after the initial assessment. A follow-up ultrasound scan was performed three months after the completion of the therapeutic sessions to assess the anatomical healing of the rotator cuff tear.ResultsRepeated measurements analysis indicated a significant improvement in pain scores, functionality, and patients’ quality of life (P value < 0.001). Comparison of the two treatment methods did not reveal any significant differences (P value > 0.05) despite the fact that the MENS was associated with a greater improvement in pain intensity and TENS with a greater improvement in functionality and quality of life.ConclusionsUsing MENS and TENS appears to be equally effective in terms of pain relief, functional improvement, and quality of life enhancement in patients.