Acupuncture Management of Frozen Shoulder

Lee, David Robert Kittak (2006). Acupuncture Management of Frozen Shoulder Master's Thesis, School of Population Health, University of Queensland.

       
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Author Lee, David Robert Kittak
Thesis Title Acupuncture Management of Frozen Shoulder
School, Centre or Institute School of Population Health
Institution University of Queensland
Publication date 2006
Thesis type Master's Thesis
Supervisor Associate Professor Peter O'Rourke
Abstract/Summary Background: Frozen shoulder or idiopathic adhesive capsulitis is an enigma of musculo-skeletal medicine. It is a difficult condition to treat and its etiology is still unknown. Aim: The aim of this study is to investigate whether acupuncture has a role in the management of frozen shoulder. Objectives: An in-depth literature review was conducted on all aspects related to the current concepts and treatments for frozen shoulder. Although there were discussions on associated conditions and possible causes of frozen shoulder, there is currently no consensus on its management. Acupuncture has been used successfully as a treatment for frozen shoulder by many eastern practitioners. Unfortunately, their claims could not be substantiated due to a lack of properly conducted clinical trials. An acupuncture treatment protocol for the management of frozen shoulder was designed based on both Traditional Chinese Medicine (TCM) and Anatomical principles. This protocol was then tested with a clinical trial. Methods: A pilot study, using a prospective case series of 20 patients suffering with the “adhesive phase” of frozen shoulder, was conducted to test the effectiveness of the acupuncture treatment protocol. This study included specific selection and exclusion criteria; an objective assessment of the range of movement and subjective assessments on the quality of life and pain. All data were collated and analysed with SPSS version 12. The pretreatment and post-treatment data were tested using both parametric paired sample t test and non-parametric Wilcoxon signed-rank test. Results: The patients’ profile confirmed the affected age group and gender distribution to be similar to those in the literature search. Unfortunately, due to the small sample size, there were no significant associated conditions demonstrated. There were twice as many cases of primary frozen shoulder than secondary frozen shoulder in this study. These analyses suggested that there were significant changes in all three areas of assessment – range of shoulder movement, quality of life and visual analogue pain scale (p<0.001). At completion of treatment, the result revealed that the acupuncture treatment protocol was successful in 60%, and moderately successful in 15%, of the 20 cases tested. This outcome was compared with the study by Omari and Bunker which showed only 12% success with conservative western medical treatments, suggesting that acupuncture may be better than conservative western medical treatments. Conclusion: Acupuncture treatment is less costly and has minimal side effects. It should be part of the non-procedural modalities offered to patients suffering with frozen shoulder. For patients who have failed western conservative managements, a trial of acupuncture treatment should be considered prior to embarking on the more invasive interventions..
Keyword Frozen shoulder
adhesive phase
acupuncture
pilot study

 
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