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超声引导下肱盂关节注射治疗肌萎缩侧索硬化症肩部疼痛:病例系列

Ultrasound-guided glenohumeral joint injections for shoulder pain in ALS: A case series.

作者信息

Burke Katherine M, Ellrodt Amy S, Joslin Benjamin C, Sanpitak Pia P, MacAdam Claire, Deo Prabhav, Ozment Kevin, Shea Cristina, Johnson Stephen A, Ho Doreen, Chu Samuel K, Babu Ashwin N, Franz Colin K, Paganoni Sabrina

机构信息

Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States.

Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.

出版信息

Front Neurol. 2023 Feb 2;13:1067418. doi: 10.3389/fneur.2022.1067418. eCollection 2022.

Abstract

INTRODUCTION

Shoulder pain is a common secondary impairment for people living with ALS (PALS). Decreased range of motion (ROM) from weakness can lead to shoulder pathology, which can result in debilitating pain. Shoulder pain may limit PALS from participating in activities of daily living and may have a negative impact on their quality of life. This case series explores the efficacy of glenohumeral joint injections for the management of shoulder pain due to adhesive capsulitis in PALS.

METHODS

People living with ALS and shoulder pain were referred to sports medicine-certified physiatrists for diagnostic evaluation and management. They completed the Revised ALS Functional Rating Scale and a questionnaire asking about their pain levels and how it impacts sleep, function, and quality of life at baseline pre-injection, 1-week post-injection, 1 month post-injection, and 3 months post-injection.

RESULTS

We present five cases of PALS who were diagnosed with adhesive capsulitis and underwent glenohumeral joint injections. Though only one PALS reported complete symptom resolution, all had at least partial symptomatic improvement during the observation period. No complications were observed.

CONCLUSIONS

People living with ALS require a comprehensive plan to manage shoulder pain. Glenohumeral joint injections are safe and effective for adhesive capsulitis in PALS, but alone may not completely resolve shoulder pain. Additional therapies to improve ROM and reduce pain should be considered.

摘要

引言

肩部疼痛是肌萎缩侧索硬化症患者(PALS)常见的继发性损伤。因肌无力导致的活动范围(ROM)减小会引发肩部病变,进而导致使人衰弱的疼痛。肩部疼痛可能会限制PALS参与日常生活活动,并可能对他们的生活质量产生负面影响。本病例系列探讨了盂肱关节注射治疗PALS因粘连性关节囊炎所致肩部疼痛的疗效。

方法

患有肌萎缩侧索硬化症且有肩部疼痛的患者被转介给具有运动医学认证的物理治疗师进行诊断评估和治疗。他们在注射前基线、注射后1周、注射后1个月和注射后3个月完成了修订的肌萎缩侧索硬化症功能评定量表以及一份关于疼痛程度及其对睡眠、功能和生活质量影响的问卷。

结果

我们呈现了5例被诊断为粘连性关节囊炎并接受盂肱关节注射治疗的PALS病例。虽然只有1例PALS报告症状完全缓解,但在观察期内所有患者均至少有部分症状改善。未观察到并发症。

结论

肌萎缩侧索硬化症患者需要一个全面的计划来管理肩部疼痛。盂肱关节注射对PALS的粘连性关节囊炎是安全有效的,但单独使用可能无法完全消除肩部疼痛。应考虑采用其他疗法来改善活动范围并减轻疼痛。

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