Department of Anesthesiology, Ege University Faculty of Medicine, Pain Clinic, Bornova-Izmir-Turkey.
Eur J Phys Rehabil Med. 2010 Sep;46(3):315-24. Epub 2010 Apr 13.
Rotator cuff problems are common causes of pain and restriction of movement in shoulder. The aim of this study to compare the effect of intra-articular injection of corticosteroid and conventional transcutaneous electrical nerve stimulator (TENS) treatment in treatment of rotator cuff tendinitis.
Subjects were randomly allocated into Group 1 (intra-articular injection of corticosteroid) and Group 2 (conventional transcutaneous electrical nerve stimulation-TENS). Outcome measurements were performed using the Visual Analogue Scale (VAS) for pain, range of motion (ROM), the Shoulder Disability Questionnaire (SDQ), the Short Form-36 (SF-36), and Beck Depression Scale (BDS) questionnaires and paracetamol consumption.
In both groups, significant improvement was observed in all weeks in VAS, ROM and SDQ scores (P<0.05). Improvement was detected in most of the SF36 scores at the end of the treatment in both groups (P<0.05), while no significant change was observed in BDI score (P>0.05). In both treatment groups, paracetamol consumption decreased in time (P<0.05). When the groups were compared, a significant difference was found between the groups in favor of Group 1 in terms of VAS-at night and VAS-at rest in weeks 1, 4 and 12, and VAS-during movement in week 1 and 12 (P<0.05). The comparison of two groups revealed a significant difference in favor of Group 1 in weeks 1 in the passive abduction and the active and passive IR ROM measurements (P<0.05). There was also a significant difference in favor of Group 1 observed in weeks 1 in SDQ scores (P<0.05).
Intra-articular injection of corticosteroid and conventional TENS are efficient in the treatment of rotator cuff tendinitis. When two treatments are compared, it may be concluded that intra-articular steroid injection was more effective especially in the first weeks regarding pain, ROM and disability. Otherwise, use of TENS allow to patients to increase activity level, improve function and quality of life like that in our study. TENS, as it is cheaper, non-invasive, more easily performed and efficient, may be preferable for the treatment of shoulder pain. Further studies are needed to include these results in the prospective treatment guidelines.
肩袖问题是肩部疼痛和运动受限的常见原因。本研究旨在比较关节内注射皮质类固醇和常规经皮神经电刺激（TENS）治疗肩袖肌腱炎的效果。
将受试者随机分为 1 组（关节内注射皮质类固醇）和 2 组（常规经皮神经电刺激-TENS）。使用视觉模拟量表（VAS）评估疼痛、运动范围（ROM）、肩关节残疾问卷（SDQ）、36 项简短健康调查问卷（SF-36）和贝克抑郁量表（BDS）评估结果，并记录扑热息痛的使用情况。
两组在第 1、2、4 和 12 周时 VAS、ROM 和 SDQ 评分均显著改善（P<0.05）。两组在治疗结束时大多数 SF36 评分均有所改善（P<0.05），而 BDI 评分无显著变化（P>0.05）。两组的扑热息痛使用量均随时间减少（P<0.05）。组间比较发现，1 组在第 1、4 和 12 周时 VAS-夜间和 VAS-休息时、第 1 和 12 周时 VAS-运动时，以及第 1 周时的被动外展和主动及被动内旋 ROM 测量方面明显优于 2 组（P<0.05）。第 1 周时，1 组的 SDQ 评分明显优于 2 组（P<0.05）。
关节内注射皮质类固醇和常规 TENS 均能有效治疗肩袖肌腱炎。两种治疗方法比较后发现，关节内注射皮质类固醇治疗在第 1 周时在疼痛、ROM 和残疾方面的效果更显著。然而，TENS 允许患者增加活动水平，改善功能和生活质量，就像我们的研究一样。由于 TENS 更便宜、非侵入性、更容易实施且有效，因此在治疗肩部疼痛方面可能更具优势。需要进一步的研究将这些结果纳入前瞻性治疗指南。
