Treatment Of Chronic Shoulder Pain Research Articles

Pulsed Mode Radiofrequency Lesioning of the Suprascapular Nerve for the Treatment of Chronic Shoulder Pain

Suprascapular nerve blockade improves pain, range of motion, and disability in acute and chronic shoulder pain. Pain relief usually lasts several hours with local anesthetic. If steroids are added, the relief lasts several weeks. Since repetitive steroid exposure is associated with several hazards, alternative long-term therapies would be desirable. Pulsed mode radiofrequency is a non-destructive, safe, and repeatable long-term pain control therapy. We report a case, wherein a series of fluoroscopically guided, suprascapular nerve pulsed mode RF treatments were performed. Each provided 4-5 months of pain relief and improvement in shoulder function, without deterioration in muscle strength.

Does Acupuncture Contribute to the Treatment of Chronic Shoulder Pain (Csp)

Objective Response of Chinese acupuncture compared to conservative orthopaedic treatment and unspecific needling in pain treatment on CSP. Design Prospective, randomized controlled trial with three blinded parallel groups; follow up three months. Setting Outpatients of 26 orthopaedists, who have attended a 140 hours training course on acupuncture. Patients Four hundred and twenty seven out-patients with a history of CSP ≥ six weeks, VAS ≥ 50 mm were selected; three random groups, six weeks treatment. 308 patients reported after three months follow up. Two strata: age 25–45 and age 46–65. Interventions Group 1: VAP: 15 treatments of verum acupuncture (VAP). Group 2: SHM: 15 treatments of non-specific needling, sham acupuncture (SHM). Group 3: COT: conventional conservative orthopaedic treatment (COT). Patients were blinded to allocation between verum and sham acupuncture. Main Outcome Measures Primary endpoint: pain reduction ≥ 50% on VAS three months after the end of the treatment protocol. Secondary endpoints: global assessments on a 4-score scale directly after the end of the treatment protocol. Results The results after three months follow up are: Highly significant effect of CAP over SHM and COT in the whole sample (P<0.0001) and in Stratum1 (P<0.001) and Stratum2 (P<0.001). Conclusions Acupuncture is an important supplement in the management of CSP. BMBF grant: 01KT9411/9

Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis

Acupuncture has gained increasing attention in the treatment of chronic pain. The lack of a satisfying placebo method has made it impossible to show whether needling is an important part of the method or whether the improvement felt by the patient is due to the therapeutic setting and psychological phenomena. Also, the effectiveness of acupuncture has not been demonstrated sufficiently. We treated 52 sportsmen with rotator cuff tendinitis in a randomised single-blind clinical trial using a new placebo-needle as control. Patients were treated for 4 weeks. The primary endpoint of the trial was the change in the modified Constant-Murley-score from the baseline. Assessment of the treatment outcome was made by experienced orthopaedists not informed of the treatment allocation. Acupuncture with penetration of the skin was shown to be more effective than a similar therapeutic setting with placebo needling in the treatment of pain. The acupuncture-group improved 19.2 Constant-Murley-score points (SD 16.1, range from −13 to 50), the control-group improved 8.37 points (SD 14.56, range from −20 to 41), (P=0.014; C.I. 2.3;19.4). This study showed that needling is an important part of the acupuncture effect in the treatment of chronic shoulder pain in athletes. No conclusions can be derived from this study concerning the importance of choosing points and the rules of Traditional Chinese Medicine. Using the new placebo method as control for other ailments could improve the evidence of specific acupuncture effects beyond pain treatment.