RESEARCH - Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicenter randomized controlled trial

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Rheumatology Advance Access published online on April 10, 2008

Rheumatology, doi:10.1093/rheumatology/ken040

Single-point acupuncture and physiotherapy for the treatment of

painful shoulder: a multicentre randomized controlled trial

J. Vas1, C. Ortega2, V. Olmo3, F. -Fernandez4, L. 4, I.

Medina5, J. M. Seminario6, A. Herrera7, F. Luna8, E. Perea-Milla9, C.

Mendez10, F. Madrazo11, C. Jimenez2, M. A. Ruiz3 and I. Aguilar1

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,

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.

Abstract

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.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken040v1?papetoc

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