• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.108-114
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• 2003

The shoulder is a complex area which makes it vulnerable to painful pathologic processes. Chronic shoulder pain has become more common recently due to increased use of computers and a ,generally more sedentary life style among most people . Trigger point injection and neural blockade are useful for the management of chronic shoulder pain which has not improved with conservative treatment. Published articles concerning trigger point injection or neural blockade for chronic shoulder pain were reviewed to evaluate promising methods. If we are careful to remain aware of the details and complications in addition to adhering to effective treatments, these should be good armamentarium for doctors enthusiastic about the management of chronic shoulder pain.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1907-1913
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• 2019

Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson's correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby analyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoulder disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened, shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.1
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• pp.510-515
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• 2013

The purpose of this study was to examine the influences of chronic shoulder pain on the muscle tone in trunk muscles. The study's subjects were 40 men and women in their 30 to 50s, which were divided into two groups. A chronic shoulder pain group consisted of 20 subjects who had been diagnosed with chronic shoulder pain by doctors, and a painless group consisted of 20 subjects who had experienced no such pain. An analysis was performed using electromyography on the muscle tone in the rectus abdominalis, external oblique, internal oblique, and erector spinae muscles under the same conditions between the two groups. The analysis results were as follows. The chronic shoulder pain group exhibited an overall high level of trunk muscle tone than the painless group, along with a statistically significant difference in the rectus abdominalis(p<.05). Moreover, the chronic shoulder pain group showed differences in the trunk muscle tone depending on the affected side. The chronic left shoulder pain group yielded higher levels of muscle tone in the right-side trunk muscles. In particular, the group revealed statistically significant differences in the rectus abdominalis and internal oblique(p<.05). The chronic right shoulder pain group exhibited higher levels of muscle tone in the left-side trunk muscles with a statistically significant difference in the internal oblique(p<.05). The above results suggested that chronic shoulder pain influences increases in the muscle tone in the trunk muscles on the opposite side to the affected shoulder.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.36-41
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• 2021

Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.

• Physical Therapy Rehabilitation Science
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• v.2 no.2
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• pp.111-114
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• 2013

Objective: Several muscles surrounding neck are vital not only for neck motion, but for upper extremities motions as well. Neck pain would affect neck and shoulder disability. The Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI), and Visual Analogue Scale (VAS) are increasingly used to evaluate treatment effectiveness after chronic neck pain. The purpose of this study was to analyze the correlation of neck pain, shoulder pain, and quality of life in patients with chronic neck pain. Design: Cross-sectional study. Methods: Forty-three patients with neck pain participated in this study. Participants were instructed to place a mark on each item of three clinical measures that best represented their experience of his/her neck and shoulder problem over the last week. The outcome measures of the study were NDI, SPADI, and VAS for neck and shoulder pain and disability. Results: The NDI was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The VAS-Neck was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Total was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and VAS-Shoulder (p<0.05). The SPADI-Pain was significantly correlated with the NDI, VAS-Neck, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Disability was significantly correlated with the NDI, VAS-Neck, SPADI-Total, SPADI-Pain, and VAS-Shoulder (p<0.05). The VAS-Shoulder was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and SPADI-Total (p<0.05). Conclusions: Neck disability in patients with chronic neck pain should be considered with disability and pain of the shoulder.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.69-78
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• 2021

Background: Approximately 30% of people suffer from chronic neck and shoulder pain. Chronic neck and shoulder pain arise due to the exposure to continuous low loading and monotonous work. This is a common musculoskeletal disorder in a society. As physical therapists, we should give appropriate treatment to these people. Methods: A total of 26 patients with chronic neck and shoulder myalgia were randomly allocated into two experimental groups. First, 13 patients received shoulder strength training, while the other 13 patients received cervical mobilization. Outcome measures included bilateral pressure pain threshold by using an algometer at upper trapezius, visual analogue scale (VAS) to express their pain scale, and muscle tension by using myoton pro device pre-intervention and after the final treatment. Results: The VAS and muscle tension in upper trapezius significantly decreased (p<.05) in both groups; however, no differences between two groups were observed (p>.05). The pressure pain threshold in upper trapezius significantly increased (p<.05) in both groups; yet, again, the differences between the groups did not reach statistical significance (p>.05). Conclusion: As methods of treatment, shoulder-specific strength training and cervical mobilization can be appropriate approaches to the treatment of neck and shoulder musculoskeletal disorder.

• Journal of Korean Physical Therapy Science
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• v.18 no.3
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• pp.63-69
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• 2011

Purpose : The purpose of study is activation of lumbar multifidus muscle by needle EMG during shoulder flexion in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymtomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. The needle EMG were measured activation of multifidus. Needle electrode was used to 28 gauge. The shoulder flexion movement used to activate the multifidus was then measured. Results : Results of the analysis showed that asymptomatic subjects had significantly larger multifidus muscle activation compared with CLBP subjects during shoulder flexion. Conclusion : This study will be used as multifidus measurement method of patient with chronic LBP. The multifidus muscle in chronic LBP patient clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Therefore chronic LBP patients necessary multifidus activation measurement with needle EMG.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.14-22
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• 2004

Purpose: To evaluate a usefulness of the simple radiograph in the patients with chronic shoulder pain 50 years and older. Material and method: 1152 patients with chronic shoulder pain and 100 asymptomatic individuals were involved in this study. All patients were 50 years and older. We excluded patients who had a history of fracture or dislocation. Radiographic interpretation was performed on a shoulder AP view, an axillary view and a supraspinatus outlet view. For statistical analysis, a chi-square test was performed. A p value of <0.05 was considered statistically significant. Results: Abnormal radiologic findings were identified in 369(32%) out of 1152 patients with a shoulder pain: greater tuberosity sclerosis, acromial sclerosis, subacromial osteophytes are common abnormal radiologic findings. A rotator cuff tear or impingement syndrome was identified on a final diagnosis in 61(85.2%) out of the 76 patients with radiologic abnormalities in both greater tuberosity and acromion (p<0.05). Abnormal radiologic findings were identified in 18% of the asymptomatic individuals. Conclusion: Simple radiographic analysis is an important primary diagnostic tool in patients (50 years and old) with chronic shoulder pain.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.106-111
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• 2021

Objective: This study covered the effect of stabilization exercise on muscle activity, shoulder painanddisability index(SPADI) oftheelderly people with chronic shoulder pain by tele-rehabilitation village hall in rural area. Design: A randomized controlled trial. Methods: The study subjects are 29 elders with chronic shoulder pain aged over 65-year-old who reside in the rural area (experimental group: 14 elders and control group: 15). The elderly people in the experimental group were asked to perform shoulder stabilization exercise 60 minutes per one time for 4 weeks and three times in a week and the others in the control group were asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior and the lower trapezius. In addition, SPADI is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of the three muscles (upper trapezius, serratus anterior, lower trapezius), and SPADI. Conclusions: It is found that shoulder stabilization exercise is effective in muscleactivity, pain and ability of the elderly people through tele-rehabilitation service. This study should be used for improving the quality of the elderly people's lives through active tele-rehabilitation service for areas where have poor medical benefits.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.507-510
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• 2013

Objective : The aim of this study was to evaluate effect of pulsed radiofrequency (PRF) neuromodulation of suprascpaular nerve (SSN) in patients with chronic shoulder pain due to adhesive capsulitis and/or rotator cuff tear. Methods : The study included 11 patients suffering from chronic shoulder pain for at least 6 months who were diagnosed with adhesive capsulitis (n=4), rotator cuff tear (n=5), or adhesive capsulitis+rotator cuff tear (n=2) using shoulder magnetic resonance imaging or extremity ultrasonography. After a favorable response to a diagnostic suprascapular nerve block twice a week (pain improvement >50%), PRF neuromodulation was performed. Shoulder pain and quality of life were assessed using a Visual Analogue Scale (VAS) and the Oxford Shoulder Score (OSS) before the diagnostic block and every month after PRF neuromodulation over a 9-month period. Results : The mean VAS score of 11 patients before PRF was $6.4{\pm}1.49$, and the scores at 6-month and 9 month follow-up were $1.0{\pm}0.73$ and $1.5{\pm}1.23$, respectively. A significant pain reduction (p<0.001) was observed. The mean OSS score of 11 patients before PRF was $22.7{\pm}8.1$, and the scores at 6-month and 9 month follow-up were $41.5{\pm}6.65$ and $41.0{\pm}6.67$, respectively. A significant OSS improvement (p<0.001) was observed. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective treatment for chronic shoulder pain, and the effect was sustained over a relatively long period in patients with medically intractable shoulder pain.