| Objective:To compare the long-term effects of a single cortisone injection and a three week treatment course of acupuncture on pain and disability in patients suffering from primary adhesive capsulitis.Methods:41 patients suffering from AC for >3 months, were divided into two groups, acupuncture group and cortisone group. The cortisone group got injected with either 40 mg triamcinolone hexacetonide (2ml) or isotonic saline (2 ml) mixed with 2-3 cc of 1% lidocaine solution directly into the glenohumeral joint capsule. The acupuncture group was treated with electro acupuncture every other day for three weeks, with local point on the shoulder (LI-14 臂臑, LI-15 肩髃，LI-16 巨骨, SI-10 臑俞, SJ-14 肩髎, M-UE-48 肩前), and with points treating their individual TCM patterns, followed by cupping treatment over the shoulder. Both groups were also taught a simple training program that they would preform three times every day. Patient assessment was done as baseline, before treatment, directly after treatment (after injections in the cortisone group, and after the last treatment of the treatment course in the acupuncture group) and finally 12 weeks following treatment. The primary outcome measure was improvement in the Shoulder Pain And Disability Index (SPADI) score at end point 12 weeks after ended treatment.Results:12 weeks after treatment there was a statistical significant difference from baseline SPADI score in both treatment groups (P= 0.001 in the cortisone group and P= 0.001 in the acupuncture group). Though the mean total SPADI score reduction in the acupuncture group was significantly lower than that of the cortisone group (P= 0.025). In the after treatment assessment the mean SPADI score of the cortisone group was significantly lower that that of the acupuncture group (P<0.001), and the lowest mean score at any time in both treatments. But the mean cortisone group total SPADI score increased by 19 points from after treatment to end point, while in the other hand the acupuncture group score had a slight decrease of 2.5 points from after treatment to endpoint.Conclusion:A cortisone injection provides a quick and easy pain reduction in patients with AC, but with limited long-term effects (further investigation is need to totally map out the effects). There is also adverse effects form the drug if it is frequently injected into the same local area. Acupuncture has no long lasting adverse effects, if it is preformed correct. The effects from acupuncture takes a longer time to achieve, and requires the patient to show up to the clinic several times a week, but the long term pain reduction is significantly better than that of cortisone injections. |
PDF Full Text Request