• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.10-17
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• 2017

Background: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. Methods: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. Results: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. Conclusions: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.105-108
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• 1996

Localized or radiating pain in the arm and shoulder joint may result after faulty alignment causing compression or tension on nerves, blood vessels, or supporting soft tissues. The critical site of faulty alignment is the quadrangular space in the axilla bounded by the teres major, teres minor, long head of triceps, and humerus. The axillary nerve emerges through this space to supply the deltoid and teres minor. The activity of the trigger point on teres minor compressing the axillary nerve causes pain to develop through the area of sensory distribution of cutaneous branch of the axillary nerve. Relieving compression on the axillary nerve and suprascapular nerve is the key point to relieving the pain. Spasm of the supraspinatus and infraspinatus compressing the suprascapular nerve caused pain to develop in the shoulder joint and scapular area. We treated those patients experiencing such pain with local anesthetic infiltration or I-R laser stimulation on the identified trigger points.

• PNF and Movement
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• v.19 no.3
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• pp.401-412
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• 2021

Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.

• The Journal of Korean Medicine
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• v.20 no.3 s.39
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• pp.115-126
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• 1999

OBJECTIVES: In order to study the effect of scapular girdle taping on hemiplegic shoulder pain, a clinical study was performed. . METHODS: Forty patients with hemiplegic shoulder pain were randomized into two groups. Twenty patients underwent a standard acupuncture treatment for shoulder pain (named control group). The other twenty patients underwent the same acupuncture treatment, but scapular girdle taping was added after acpuncture treatment (named sample group). Tapes were applied to the supraspinatus, infraspinatus, deltoid and pectoris major muscles. Shoulder pain was measured with a visual analog scale. The acupuncture treatment was performed daily for 3 weeks, and the scapular girdle taping was performed for 3 weeks in the frequency of 2 times a week. RESULTS: In terms of improvement of pain, the sample group showed statistically meaningful decrease after 3 times treatment compared with control group (P<0.05). In terms of improvement of pain with shoulder subluxation, the sample group showed a statistically meaningful decrease after 3 treatments compared with the control group (P<0.05). CONCLUSIONS: These results support that scapular girdle taping is significantly effective in reducing hemiplegic shoulder pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.32-40
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• 2009

Purpose: The purposes of this study were to determine the intertester and intratester reliabilities of the Lateral Scapular Slide Test (LSST) method, and to examine if significant differences existed in scapular positions among the pain groups (right-shoulder pain group, left-shoulder, pain group and both-shoulders pain group). 27 female subjects (mean age = 51.6, mean height = 157.7 cm, mean weight = 57.5 kg) with shoulder pain were recruited for this study. Methods: The bilateral distances between the root of the scapular spine and T3/4 (RSS), and between the inferior scapular angle and T7/8 (IA), were recorded. Subjects were tested at three positions: the with arms with abducted at 0, 45 and 90 degrees in the coronal plane. The LSST measurements were performed by two testers, selected randomly. Results: The results were as follows: Intraclass correlation coefficients (ICCs) for the intertester reliability were excellent (ICC 0.78-0.94). And the ICCs for the intratester reliability were excellent (ICC 0.83-0.99). In the right-shoulder and both-shoulders pain groups, the right-side RSS and IA values of right side were significantly greater than of the left-side RSS values left side for the arms abducted at 0 degrees of right shoulder pain group and both shoulder pain group (p<.05). However, the side-to-side difference was less than 1.5 cm. Conclusion: Our results suggest that the LSST is highly reliable in identifying the abnormal scapular position of patients with shoulder problems. Future research should be continued to clarify the clinical usefulness of this method.

• The Journal of Korean Physical Therapy
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• v.29 no.1
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• pp.7-15
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• 2017

Purpose: This randomized controlled trial was conducted to compare the effectiveness of global postural reeducation to segmental stretching in subjects with neck and shoulder pain. Methods: Sixteen subjects with neck and shoulder pain were randomized into two intervention groups, a global posture reeducation group (n=8) that performed muscle chain stretching, and a segmental stretching group (n=8) that performed conventional static muscle stretching. The intervention program consisted of two 40 minutes individual sessions per week for four weeks. Subjects were evaluated pre-intervention, two-week after intervention and at a four-week follow-up appointment for pain intensity, disability and health-related quality of life. Two-way repeated analysis of variance was used for between-time and between-group comparisons. The significance level was 0.05. Results: Significant pain relief and decreasing discomfort of the neck and shoulder were observed after intervention in both groups, and there was an interaction between time lapse and groups (pain, F=10.31, neck disability, F=25.45, shoulder disability, F=12.82, p<0.05). Quality of life also improved after intervention in both groups. Moreover, the physical components score improved, and a significant interaction was observed between time and groups (F=4.85, p<0.05). However, no significant improvement in mental component score of quality of life and no significant interaction between time and groups were observed (p>0.05). Conclusion: These findings suggest that a GPR intervention in subjects with neck and shoulder pain induces greater improvement of pain and disability and quality of life than segmental stretching.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.164-167
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• 2008

Frozen shoulder is known to be a self-limited disease, and it is associated with chronic pain and limitation of joint movement. Although its etiology is still unknown, frozen shoulder is associated with several diseases. The diagnosis is made based on the medical history, the clinical and radiological examinations and exclusion of other shoulder pathologies. The skeleton is one of the most common sites of metastasis in patients with lung cancer. It has been reported that the incidence of bone metastases in lung cancer patients is approximately 30-40%, and the median survival time of patients with such metastases is 6-7 months. We experienced a case of a 77-year-old female patient who complained of right shoulder pain and limited joint mobility, and these symptoms were due to metastatic lung cancer in the shoulder.

• Journal of Korean Physical Therapy Science
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• v.31 no.1
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• pp.33-45
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• 2024

Background: This study aimed to investigate the effect of elastic band-resistive exercise using audio-visual medium on pain, proprioception, and motor function in adults with chronic neck and shoulder pain. Design: One group pretest-posttest follow-up experimental design. Method: Twenty adult women with neck and shoulder pain voluntarily participated in this study. Elastic band-resistive exercise using audio-visual medium including cervical flexion and extension, shoulder external rotation, and scapular retraction-protraction motions was conducted 5 times a week for 3 weeks. The Numerical Rating Scale, pressure threshold tool, CROM goniometer, and Image J software were used to assess subjective pain level, tenderness threshold (pain), joint position sense error (proprioception), joint range of motion, and postural alignment (motor function), respectively. Result:: The pain intensity and threshold and joint position sense error showed significant decreases after the intervention, whereas the joint range of motion angle revealed significant increases. The postural alignment including forward head posture and rounded shoulder revealed significant improvements after the intervention. Conclusions: Therefore, we suggest that elastic band-resistive exercise through audio-visual medium would be helpful in preventing and managing pain and physical dysfunction in individuals with chronic neck and shoulder pain, and then it would support the development of health management-related online education content.

• Journal of Acupuncture Research
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• v.32 no.4
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• pp.177-186
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• 2015

Objectives : This study was performed to analyze treatment outcomes of idiopathic and secondary frozen shoulder patients with clinical characteristics, as well as percentage of pain reduction, and to find out relevant factors for pain reduction in the frozen shoulders of each patient group. Methods : Data were collected from outpatients who visited the Acupuncture and Moxibustion department and treated with traditional Korean Medical treatments at a Korean Medicine Hospital from June 12, 2006 to June 30, 2015. Patients were divided into two groups; idiopathic and secondary frozen shoulder, based on imaging and medical records. Clinical characteristics (demographic characteristics, disease characteristics, treatment characteristics) and percentage pain reduction were collected. Percentage pain reduction was compared between two groups and relevant factors for pain reduction were analyzed. Results : 78 outpatients'medical records were reviewed. There was no significant difference of clinical characteristics between idiopathic and secondary frozen shoulder patients. In percentage pain reduction, there was no significant difference between the two groups. In the idiopathic frozen shoulder group, patients who had a short duration from the onset had a tendency for less pain (p<0.05). In the secondary frozen shoulder group, patients taking herbal medicine experienced significantly less pain (p<0.05). Conclusions : We could find no significant difference in percentage pain reduction with traditional Korean medicine between idiopathic and secondary frozen shoulder. Duration from the onset could be relevant in percentage pain reduction in idiopathic frozen shoulder, and taking herbal medicine could be relevant in the percentage pain reduction in secondary frozen shoulder.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.245-248
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• 2016

A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.