Rheumatology Advance Access published online on April 10, 2008
Rheumatology, doi:10.1093/rheumatology/ken040
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Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial
1Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, 2Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, 3Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, 4Rehabilitation Medicine Department, Military General Hospital, Cartagena, 5Physiotherapy Department, University of Malaga, Malaga, 6Anaesthesia Department, Serrania Hospital, Ronda, Malaga, 7Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, 8Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, 9Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, 10Information and Assessment Service, Department of Health, Seville and 11Rehabilitation Medicine Department, Valme Hospital, Seville, Spain.
Correspondence to:
J. Vas, Pain Treatment Unit, Healthcare Centre Doña Mercedes, Calle Segovia s/n, 41700 Dos Hermanas, Spain. E-mail: jorgef.vas.sspa{at}juntadeandalucia.es
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Abstract |
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Objective. Evaluate the efficacy of acupuncture associated with physiotherapy for patients with painful shoulder.
Methods. In a multicentre controlled randomized study, participants were recruited with a clinical diagnosis of unilateral subacromial syndrome from six rehabilitation medicine departments belonging to the Public Health System in two Spanish regions. All participants received 15 sessions of physiotherapy during the 3 weeks that the treatment lasted and were randomized to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The primary outcome measure was the change in the Constant–Murley Score (CMS) for functional assessment of the shoulder, at 4 weeks after randomization. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN28687220 [controlled-trials.com] .
Results. A total of 425 patients were recruited. The mean score (S.D.) on the CMS had increased by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5) points in the control group, and the mean difference between the two groups was statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% among the control group (P < 0.001).
Conclusions. Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.
KEY WORDS: Shoulder pain, Acupuncture, Randomized clinical trial, Physiotherapy, Pain treatment, Single-point acupuncture, Subacromial syndrome, Rotator cuff tendinitis, Subacromial bursitis, Mock transcutaneous electrical nerve stimulation
Submitted 12 September 2007;
revised version accepted 15 January 2008.
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