• Title/Summary/Keyword: Shoulder impingement

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Short-term Low-dose Oral Corticosteroid Therapy of Impingement Syndrome of the Shoulder: A Comparison of the Clinical Outcomes to Intra-articular Corticosteroid Injection

  • Kim, Young Bok;Kim, Young Chang;Kim, Ji Wan;Lee, Sang Jin;Lee, Sang Won;Choi, Hong Joon;Lee, Dong Hyun;Kim, Joo Young
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.50-56
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    • 2014
  • Background: To assess the clinical outcomes of short-term oral corticosteroid therapy for impingement syndrome of the shoulder and determine whether it can be substituted as an alternative to the intra-articular injection. Methods: The clinical outcomes of the 173 patients, the oral steroid group (n=88) and the injection group (n=85), were measured at 3 weeks, 2, 4, and 6 months postoperatively. The clinical outcomes were assessed by measuring the the University of California at Los Angeles (UCLA) score, visual analog scale (VAS) and range of motion (ROM) at every follow-up. Any complications and recurrence rate were noted. A relationship between the treatment outcomes and factors such as demographic factors, clinical symptoms and radiographic findings were determined. Results: No difference was observed in VAS and UCLA scores between the two groups, but forward flexion and internal rotation of ROM were significantly improved in the injection group at the 2nd and 4th postoperative month (p < 0.05). At 6th postoperative month, recurrence rate of symptoms was 26% in the oral steroid group and 22% in the injection group. No major adverse effects were observed. When the clinical outcomes of the oral steroid group were compared to either demographic, clinical symptoms, or radiographic findings, UCLA score was found to be significantly low (p < 0.05) in patients with joint stiffness and UCLA score, whereas VAS score was significantly improved in patients with night pain (p < 0.05). Conclusions: Short-term low-dose oral corticosteroid therapy of impingement syndrome showed comparable clinical outcomes to intra-articular injection without any remarkable adverse effects. Low-dose oral steroids can be regarded as a partial alternative to intra-articular injection for the initial therapy of impingement syndrome of the shoulder.

Acupuncture Treatment for Shoulder Impingement Syndrome: A Review of Randomized Controlled Trials

  • Park, Jae Eun;Kim, Woo Young;Lee, Soo Jin;Oh, Da Yoon;Lee, Min Cheol;Jeon, Myung Kyu;Kim, Hyeon Jin;Ahn, Jae Young;Yang, Su Hyeon;Choi, Yun Young;Shin, Na Young;Nam, Hye Jin
    • Journal of Acupuncture Research
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    • v.38 no.3
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    • pp.175-182
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    • 2021
  • To evaluate the effectiveness of acupuncture treatment for shoulder impingement syndrome (SIS) a literature review was conducted of randomized controlled trials (RCTs) where acupuncture was used as an intervention for patients diagnosed with SIS. Relevant clinical studies (N = 181) were retrieved from several databases based on the inclusion/exclusion criteria, and the interventions and results were analyzed. Six RCTs were selected to review based on the inclusion and exclusion criteria. In all 6 studies, the acupuncture treatment group showed significant positive changes in indicators evaluating pain, disability, and quality of life. A significant decrease in the evaluation indicators (Shoulder Pain and Disability Index, numeric rating scale, Visual Analogue Scale, Constant Murley Shoulder Assessment Score, patient's global assessment, and doctor's global assessment) and a significant increase in the questionnaire scores (UCLA, AL-score, EuroQol 5 Dimension Self-Report Questionnaire, and disabilities of the arm, shoulder, and hand) were observed. In addition, 1 study showed similar improvements in pain and quality of life measures in the acupuncture group and corticosteroid injection group. No major side effects were reported. Acupuncture may be an effective and safe treatment for SIS however, further RCTs are required.

Analysis of the Effects on the Level of Pain and Functional Improvement After Integrated Korean Medicine in Patients with Shoulder Impingement Syndrome: A Retrospective Chart Review

  • Kim, Eun-song;Woo, Jae-hyuk;Lee, Hyo-eun;Lee, Hyun-seok;Lee, Soo-kyeong;Lee, Yoon-jung;Jin, So-ri
    • Journal of Acupuncture Research
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    • v.39 no.3
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    • pp.213-221
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    • 2022
  • Background: This study investigated the clinical effectiveness of Korean medicine (KM) treatment for shoulder impingement syndrome (SIS). Methods: There were 61 patients who were diagnosed with SIS in the Jaseng hospital network of KM (7 hospitals located in Korea: Gangnam, Daejeon, Bucheon, Haeundae, Bundang, Ulsan, and Gwangju) between January 1st, 2015 and December 31st, 2020 who were retrospectively reviewed. The patients were grouped according to complications, intake of analgesics, duration of illness preadmission, and treatment. Treatments consisted of herbal medicine, acupuncture, cupping, Chuna, pharmacopuncture, bee venom pharmacopuncture, medicinal steaming, Daoyin exercises, and physical therapy. By comparing the Numeric Rating Scale (NRS), Shoulder Pain and Disability Index, and European Quality of Life 5-Dimensions questionnaire scores, the effectiveness of integrated KM treatment was evaluated. Results: There were 14 males and 47 females. For inpatients diagnosed with SIS, the mean NRS score decreased from 5.78 ± 1.33 to 3.40 ± 1.43 (p < 0.001). The mean Shoulder Pain and Disability Index score decreased from 53.87 ± 14.76 to 38.56 ± 18.87 (p < 0.001), and the mean European Quality of Life 5-Dimensions questionnaire increased from 0.67 ± 0.13 to 0.76 ± 0.09 (p < 0.001) after KM treatment. Medicinal steaming (0.398; p < 0.001), acupuncture (0.290), cupping (0.288), bee venom pharmacopuncture (0.282), and Daoyin exercises (0.262; p < 0.05) had a positive correlation with improved changes in the NRS score. Conclusion: Conclusion: Treatment with integrated KM treatment improved the pain, range of motion, shoulder function, and quality of life of patients with SIS.

Evaluation of Coraco-Acromial Arch in Patients with Impingement Syndrome (견관절 충돌 증후군 환자에서 오훼 견봉궁의 자기공명 영상 평가)

  • Rhee Kwang-Jin;Byun Ki-Yong;Kwon Soon-Tae;Byun Kyu-Hwan
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.35-40
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    • 1999
  • Impingement syndrome is caused by a conflictual status between rotator cuff, subacromial bursa and anatomic and functional coracoacromial arch. The purpose of this study was to assessment the coracoacromial arch by MRI and to determine major factors among five components of coracoacromial arch. We analyzed forty-two cases of clinical impingement sign and test positive and postoperative confirmed diagnosed from March, 1991 to January, 1999. We evaluated acromial end abnormality according to the Bigliani acromial type and formation of osteophyte. Clavicular end abnormality classified flat, outward protrusion, inward protrusion to coracoacromial arch. Acromioclavicular joint abnormalities were advanced osteoarthritis and positive signal change. Coracoacromial ligament thickening was above 2 mm in oblique sagittal image. Coracoid process abnormality was inward protrusion to coracoacromial arch. All consecutive patients abnormalities were as follows: clavicular end osteophyte formation and inward protrusion to coracoacrmial arch were 30%, acromial end osteophyte formation was 28%, advanced acromioclavicular joint arthritis and osteophyte formation were 56%, coracoacromial ligament thickening was 24% and no coracoid process inward protrusion to coracoacromial arch. Impingement syndrome combined with rotator cuff tear group abnormalities were clavicular end(40%), acromial end(40%), acromioclavicular joint(20%), coracoacromialligament(20%) and coracoid process abnormality(0%) respectively. Only impingement syndrome group abnormalities were clavicular end(25%), acromial end(31%), acromioclavicular joint(62%), coracoacromial ligament(25%) and coracoid process(0%) respectively. Acromial type I(flat) were 6 cases, type II(curved) were 26 cases and type III(hooked) were 10 cases. We concluded that the most important contributing factors for impingement syndrome was acromial type and second was acromioclavicular joint arthritis and bony spur formation.

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Case Report of Treatment with Korean Medicine on a Central Post-Stroke Pain Patient who had Impingement Syndrome of the Right Shoulder (우측 어깨의 충격증후군을 동반한 뇌졸중 후 중추성 통증 환자 치험 1례)

  • Lim, Hyun-chan;Kim, Tae-ryun;Lee, Hye-in;Kim, Eun-ji;Lee, Da-eun;Jeon, Sang-yoon
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1060-1067
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    • 2017
  • Objectives: This case study examined the effects of treatment with traditional Korean medicine on a central post-stroke pain patient, who had impingement syndrome of the right shoulder. Methods: The patient received traditional Korean medical treatments, including acupuncture, warm-needling, moxibustion, and cupping, throughout the treatment period, and extracorporeal shock-wave therapy and physical therapy for part of the treatment period. The effects of treatments were measured with a manual muscle test (MMT), numerical rating scale (NRS), range of motion (ROM), and gait staging index (self-invented). Results: The clinical symptoms of the patient were improved considerably after the complete treatment. Conclusions: Traditional Korean medicine may be effective for treatment of central post-stroke pain in patients with impingement syndrome.

Shoulder Pain Treated by Manual Acupuncture and Pharmacopuncture Following Origin/Insertion Technique of Applied Kinesiology: A Case Series of Two Patients

  • Ahn, Chang-Beohm;Noh, Joon-Yong;Yoon, Hyun-Min;Kim, Cheol-Hong;Song, Ung-Kwan
    • Journal of Pharmacopuncture
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    • v.24 no.4
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    • pp.206-212
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    • 2021
  • The aim of this study was to report on the improvement of shoulder pain resulting from disorders of the rotator cuff such as impingement syndrome and adhesive capsulitis, by manual acupuncture (MA) and pharmacopuncture (PA) following origin/insertion technique (OIT) of applied kinesiology (AK). Two patients were treated with MA and PA after OIT on shoulder muscles. The Numerical Rating Scale and the assessment of the Japanese Orthopedic Association scores were used to assess the pain, and ultrasound images were taken to compare treatment outcome. This study showed that MA and PA following OIT may be an effective treatment for impingement syndrome and adhesive capsulitis.

Evaluation of the cross-sectional area of acromion process for shoulder impingement syndrome

  • Joo, Young;Cho, Hyung Rae;Kim, Young Uk
    • The Korean Journal of Pain
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    • v.33 no.1
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    • pp.60-65
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    • 2020
  • Background: Anatomic changes in the acromion have been considered a main cause of shoulder impingement syndrome (SIS). To evaluate the relationship between SIS and the acromion process, we devised a new morphological parameter called the acromion process cross-sectional area (APA). We hypothesized that the APA could be an important morphologic diagnostic parameter in SIS. Methods: We collected APA data from 95 patients with SIS and 126 control subjects who underwent shoulder magnetic resonance imaging (MRI). Then we measured the maximal cross-sectional area of the bone margin of the acromion process on MRI scans. Results: The mean of APAs were 136.50 ± 21.75 ㎟ in the male control group and 202.91 ± 31.78 ㎟ in the male SIS group; SIS patients had significantly greater APAs (P < 0.001). The average of APAs were 105.38 ± 19.07 ㎟ in the female control group and 147.62 ± 22.90 ㎟ in the female SIS group, and the SIS patients had significantly greater APAs (P < 0.001). The optimal APA cut-off in the male group was 165.14 ㎟ with 90.2% sensitivity, 91.4% specificity, and an area under the curve (AUC) of 0.968. In the female group, the optimal cut-off was 122.50 ㎟ with 85.2% sensitivity, 84.9% specificity, and an AUC of 0.928. Conclusions: The newly devised APA is a sensitive parameter for assessing SIS; greater APA is associated with a higher possibility of SIS. We think that this result will be helpful for the diagnosis of SIS.