Insights & Discussion
Auricular acupuncture relieved pain and decreased disability more effectively than physiotherapy for frozen shoulder treatment.
The research was conducted through a randomized clinical trial involving three parallel groups in an outpatient clinic at a university hospital. The 116 participants, suffering from a frozen shoulder, were randomly allocated to three groups where they underwent treatments of physiotherapy, local acupuncture, or auricular acupuncture. Assessment tools like the Shoulder Pain and Disability Index questionnaire and measures of the shoulder's active and passive ranges of motion were used to evaluate the effects of treatments both before and after their implementation.
The results of the study revealed that the most substantial improvements in active and passive ranges of motion including abduction, flexion, and passive external rotation were brought about by physiotherapy. Despite this, instances of pain reduction were more successfully achieved with acupuncture treatments, with auricular acupuncture leading the pack. In addition to this, auricular acupuncture made significant strides in improving the functional abilities of patients when compared to its counterpart treatments. Throughout the study, there were no reported side effects from any of the treatment approaches used.
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Guidelines have been developed for treating frozen shoulder using traditional Chinese medicine, with multiple therapies such as acupuncture and exercise recommended.
2023 Journal of Evidence-Based Medicine Traditional Chinese medicine for frozen shoulder: An evidence‐based guideline Qin X, Sun K, Ao Y, Liu J, Wang M, Deng Q, et al.
Practice Guideline Frozen Shoulder
The development of evidence-based guidelines followed internationally recognized standards and used the Grading of Recommendations Assessment, Development and Evaluation approach to determine the certainty of evidence and the strength of recommendations. A multidisciplinary group formed the development panel, who took into account benefits, harms, availability of resources, accessibility, and other factors. Nine clinical queries were defined after conducting a systematic literature review and a face-to-face meeting.
The guideline panel reached a consensus on twelve recommendations which included treatments like manual therapy, acupuncture, needle knife, Cheezheng Xiaotong plaster, Gutong plaster, exercise therapy and an integrated approach of traditional Chinese medicine and Western medicine. Their strength ranged from weakly recommended to consensus based. This new guideline targets clinicians and health administrators.
Electroacupuncture may be more effective than manual acupuncture for managing frozen shoulder, with larger effect sizes in terms of pain, function, and response rate.
2022 Frontiers in Medicine Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis Heo JW, Jo JH, Lee JJ, Kang H, Choi TY, Lee MS, et al.
Systematic Review Electroacupuncture Frozen Shoulder Shoulder Pain
This review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain, function, and response rates over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain compared to the control treatments. No adverse effects were reported.
EA was found to be an efficacious method for treating FS in this review. The meta-analysis showed that EA led to a greater reduction of FS pain than MA did, although with a very low certainty of evidence. In comparison to MA, EA led to a superior degree of functional improvement in FS patients, with a very low certainty of evidence. In comparison to MA, EA enhanced the response rate of FS, again with a low certainty of evidence. Compared with WM used in isolation, EA plus WM reduced FS pain with a low certainty of evidence.
Auricular acupuncture was found to improve physical and emotional aspects in patients with temporomandibular disorders, with similar results to occlusal splint treatment.
2022 Complementary Therapies in Medicine Auricular acupuncture in TMD — A sham-controlled, randomized, clinical trial Aroca JP, Cardoso PMF, Favarão J, Zanini MM, Camilotti V, Busato MCA, et al.
Randomised Controlled Trial Ear Acupuncture Temporomandibular Disorders
In the study, patients suffering from temporomandibular disorders were allocated into three groups - those who received auricular acupuncture (AA), those treated with occlusal splints (OS), and a sham group. The patients were evaluated and monitored over an eight-week period using axes I and II of the RDC-TMD according to CONSORT guidelines.
The findings revealed significant improvements in both the emotional aspects and physical aspects amidst the auricular acupuncture group and occlusal splint group. The sham group showed no improvements in the emotional aspect and only a few in the physical aspect. The comparison between the auricular acupuncture group and the occlusal splint group revealed similar number of variables with improved outcomes, indicating that the auricular acupuncture treatment was as effective as the occlusal splint treatment. On the other hand, the sham group presented a significant difference when compared to the other groups. These results strongly suggest the potential of auricular acupuncture as a treatment option for temporomandibular disorders.
Massage combined with acupuncture can better improve the range of motion of joints and daily living ability of patients with frozen shoulder complicated with cervical spondylosis.
2021 American Journal of Translational Research Effects of massage and acupuncture on the range of motion and daily living ability of patients with frozen shoulder complicated with cervical spondylosis Liu M, Liu Y, Peng C, Wang H, Xu Y, Jiao S, et al.
Randomised Controlled Trial Frozen Shoulder Shoulder Pain
A total of 164 patients with frozen shoulder treated in our hospital from June 2016 to April 2019 were recruited and divided into a control group and an observation group. There were 100 cases in the observation group, all of whom were treated with massage combined with acupuncture. Another 64 cases were enrolled in the control group, all of whom were treated with acupuncture alone. The recovery of myodynamia, rating scale of the American Shoulder and Elbow Surgeons (ASES), score of American Spinal Injury Association (ASIA), ROM score, vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1), complication rate, total effective rate, and patient satisfaction were assessed.
After treatment, patients in the observation group had better recovery of myodynamia than the control group. They also had lower VAS scores, higher life function score and total ASES scores, higher ASIA scores, higher ROM scores, lower VCAM-1 and ICAM-1 expression, lower complication rate, higher total effective rate, and higher patient satisfaction.
Acupuncture could be safe and effective for pain reduction, restoring shoulder function, and restoring flexion range of motion for frozen shoulder patients in the short term and midterm.
2020 Evidence-Based Complementary and Alternative Medicine The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP
Systematic Review Acupuncture Frozen Shoulder Shoulder Pain
In this systematic review and a meta-analysis, acupuncture had shown to be a safe treatment with a significant effect in regard to reducing pain, improving shoulder function, and flexion ROM in the short term and midterm. However, due to the small number of included studies and methodological limitations in these studies, more large-scale high-quality RCTs are warranted in order to give a robust conclusion. Future studies should compare acupuncture to other treatments and sham acupuncture. Additionally, longer follow-up time is needed for investigating the effect of acupuncture in the mid- and long term, and the duration of future FS studies follow-up should be increased to one year.
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