scholarly journals Subacromial Tenoxicam Injection in the Treatment of Impingement Syndrome

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0019
Author(s):  
Hakan Çift ◽  
Feyza Ünlü Özkan ◽  
Ali Şeker ◽  
Mehmet İşyar ◽  
Erman Ceyhan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Adhesive Capsulitis ◽  
Adhesion Formation ◽  
Impingement Syndrome ◽  
Therapeutic Effects ◽  
Women Patients ◽  
Alternative Treatment Option ◽  
Vas Scores ◽  
The Mean

Objectives: As subacromial bursa injection is widely used for pain relief and functional improvements in patients with periarticular shoulder disorder, we aimed to present our results of subacromial tenoxicam injection in the treatment of impingement syndrome. Methods: Patients presented to the Department of Orthopaedics and Traumatology, Istanbul Medipol University with the primary complaints of shoulder pain from January 2012 to June 2013 were selected. Those who met the following inclusion criteria were finally considered: 1) who had a clinical sign of a painful arc and positive in Hawkins test and/or Neer impingement sign; 2) who had a precise rotator cuff injury including partial cuff tears, or subacromial bursitis detected during ultrasonography or MRI. The exclusion criteria were as follows: 1) who underwent shoulder surgery; 2) who had full thickness rotator cuff rupture; 3) who had hemiplegic shoulder pain; and 4) who displayed any suspected fracture on X-ray or had a recent shoulder trauma; 5) who showed limited active ROM and stiffness due to adhesive capsulitis. Thirty one shoulders out of thirty patients were treated with subacromial tenoxicam injection. Ten of them were left shoulders. Fifteen of the patients were women.. Patients had a mean age of 51.6 (30-73). Patients were evaluated 4 times. Before the first injection, 1 week after the first injection, 2 weeks after the second injection and 3 weeks after the third injection. In every injection 20 mg tenoxicam was performed. Results: In order to relieve the pain; two patients were given only one injection, thirteen patients were given two injections and “3 injections protocol” were done to fifteen patients. The mean pre- and posttreatment VAS scores were 7.9 (between, 7-9) and 2.7 (between, 2-4) points respectively. The average pre and posttreatment DASH scores were 59.41 (between, 45-80) and 14 (between, 8.3-25.8) points respectively. The mean pre and posttreatment range of motion were 106.1 (between, 80-130 and 170i7 (between, 140-180) degrees respectively. Differences between all pre- and post-treatment parameters were statistically significant (p<0.05). Conclusion: Tenoxicam is a cheap NSAID and an analgesic of the oxicam class, is closely related to proxicam, and has a long half-life, which enables it to be administrated once daily. It also readily penetrates the synovial fluid and intraarticular intravenous administration provides superior postoperative analgesic benefits. Tenoxicam also has the ability to prevent adhesion formation. Besides it has no detrimental effect on cartilage structure. It can be safely administrated intraarticularly. Given the positive therapeutic effects of subacromial tenoxicam injection, it can be used as an alternative treatment option.

Long-Term Effects of Middle Ear Tendon Resection on Middle Ear Myoclonic Tinnitus, Hearing, and Hyperacusis

2017 ◽  
Vol 22 (6) ◽  
pp. 343-349 ◽  
Author(s):  
Dong-Kee Kim ◽  
Jung Mee  Park ◽  
Jung Ju Han ◽  
Yun Min Chung ◽  
Jung Min Kim ◽  
...  
Keyword(s):  
Middle Ear ◽  
Complete Recovery ◽  
Stress Index ◽  
Therapeutic Effects ◽  
Long Term Effects ◽  
Vas Scores ◽  
The Mean ◽  
High Control

Objective: To evaluate the therapeutic effects of middle ear tendon resection (METR) on middle ear myoclonic tinnitus (MEMT) and to investigate its long-term effects on hearing and hyperacusis. Materials and Methods: Thirty-seven patients with MEMT with a mean age of 33.2 ± 11.8 years were included in this study. METR was performed on all 37 MEMT patients (41 ears) between November 2004 and August 2016. The mean follow-up period was 16.1 months. We examined changes in tinnitus and accompanying stress and depression in patients after surgery, and examined the hearing changes and the occurrence of complications including hyperacusis. Results: After surgery, 34 (91.9%) patients exhibited complete resolution of MEMT during their follow-up period, and 3 patients showed a partial response. The mean Visual Analog Scale (VAS) scores for tinnitus severity, the Tinnitus Handicap Inventory (THI), and stress index decreased significantly after surgery (p < 0.05, paired t test). No patient developed hearing loss or hyperacusis following surgery. Preexisting hyperacusis even improved in most of the patients with intractable MEMT after surgery. Recurrence of the symptom occurred in only 1 patient, who underwent revision surgery with improvement. We observed 1 case of postoperative delayed facial palsy with complete recovery in 2 weeks. Conclusions: METR seems to be an effective and safe treatment option for intractable MEMT, considering its high control rate of tinnitus and no long-term harmful effects on hearing and hyperacusis.

scholarly journals Ultrasound-Guided Hydrodilatation With Triamcinolone Acetonide for Adhesive Capsulitis: A Randomized Controlled Trial Comparing the Posterior Glenohumeral Recess and the Rotator Cuff Interval Approaches

2021 ◽  
Vol 12 ◽  
Author(s):  
Jia-Chi Wang ◽  
Po-Yi Tsai ◽  
Po-Cheng Hsu ◽  
Jian-Ru Huang ◽  
Kevin A. Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Range Of Motion ◽  
Triamcinolone Acetonide ◽  
Shoulder Pain ◽  
Visual Analog Scale ◽  
Controlled Trial ◽  
Adhesive Capsulitis ◽  
Analog Scale ◽  
Randomized Controlled

For patients with adhesive capsulitis, hydrodilatation is typically performed using corticosteroids with ultrasound guidance via the posterior glenohumeral recess. Recently, a new intervention technique via the rotator cuff interval has been described. This study aimed to compare the efficacy of hydrodilatation with triamcinolone acetonide via the posterior glenohumeral recess and the rotator cuff interval in patients with adhesive capsulitis. This prospective randomized controlled trial was conducted in a tertiary care center with a follow-up period of 12 weeks. We enrolled 64 patients diagnosed with shoulder adhesive capsulitis. The subjects were randomly assigned to two groups that received hydrodilatation with corticosteroids either through the posterior glenohumeral recess or though the rotator cuff interval. The injection contained 4 ml of triamcinolone acetonide (40 mg) mixed with 4 ml of 2% lidocaine hydrochloride and 12 ml of normal saline. The shoulder pain and disability index, visual analog scale for pain, and range of motion were analyzed before and at 6 and 12 weeks after the treatment. Both groups experienced improvements in the visual analog scale scores, shoulder pain and disability index scores, and range of motion throughout the study period. A significant group-time interaction was observed in terms of the visual analog scale for pain during motion (p = 0.019), favoring hydrodilatation through the rotator cuff interval. Thus, hydrodilatation through the rotator cuff interval might be a better treatment option than that through the posterior glenohumeral recess for patients with adhesive capsulitis, considering its superior effect in alleviating pain during shoulder movement.

scholarly journals How do people perceive different labels for rotator cuff disease? A content analysis of data collected in a randomised controlled experiment

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052092
Author(s):  
Joshua R Zadro ◽  
Zoe A Michaleff ◽  
Mary O'Keeffe ◽  
Giovanni E Ferreira ◽  
Romi Haas ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Poor Prognosis ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Rotator Cuff Disease ◽  
Cuff Tear ◽  
Randomised Controlled

ObjectivesExplore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.SettingWe performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.Participants1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels: subacromial impingement syndrome, rotator cuff tear, bursitis, rotator-cuff-related shoulder pain, shoulder sprain and episode of shoulder pain.Primary and secondary outcomesParticipants answered two questions (free-text response) about: (1) words or feelings evoked by the label; (2) what treatments they feel are needed. Two researchers iteratively developed coding frameworks to analyse responses.Results1308/1626 (80%) complete responses for each question were analysed. Psychological distress (21%), uncertainty (22%), serious condition (15%) and poor prognosis (9%) were most often expressed by those labelled with subacromial impingement syndrome. For those labelled with a rotator cuff tear, psychological distress (13%), serious condition (9%) and poor prognosis (8%) were relatively common, while minor issue was expressed least often compared with the other labels (5%). Treatment/investigation and surgery were common among those labelled with a rotator cuff tear (11% and 19%, respectively) and subacromial impingement syndrome (9% and 10%) compared with bursitis (7% and 5%).ConclusionsWords or feelings evoked by certain labels for rotator cuff disease and perceived treatment needs may explain why some labels drive management preferences towards surgery and imaging more than others.

scholarly journals Efficiency of local hyaluronic acid injections in subacromial impingement syndrome

2019 ◽  
Vol 57 (3) ◽  
pp. 345-348
Author(s):  
V. A. Nesterenko ◽  
A. E. Karateev ◽  
E. I. Byalik ◽  
M. A. Makarov ◽  
S. A. Makarov ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Shoulder Pain ◽  
Tendon Injury ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Serious Adverse Events ◽  
Subacromial Injection ◽  
The Mean ◽  
Chronic Shoulder Pain

Chronic shoulder pain associated with subacromial impingement syndrome (SIS) is a common pathology that causes suffering and disability. One of the treatments for SIS is the local injection of hyaluronic acid (HA) preparations.Objective:to evaluate the efficiency of subacromial injection of HA in chronic shoulder pain associated with SIS.Subjects and methods.A study group consisted of 31 patients (48.4% of women and 51.6% of men; mean age 53.8±15.2 years) with chronic shoulder pain (>3 months) that had occurred after rotator tendon injury confirmed by ultrasound and/or magnetic resonance imaging. All the patients received two subacromial injections of 40 mg HA in 2 ml at a 7-day interval. The efficacy criteria were the changes of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at 1, 3 and 6 months.Results and discussion.During the treatment, there was a considerable improvement in all measures. At baseline and 1, 3, and 6 months, the mean pain severity measured on VAS was 60.0±20.0, 40.0±25.4, 31.6±26.0, and 32.2±26.5 mm (p<0.001), the mean ASES scores were 53.64±16.43, 70.08±17.70, 86.13±12.86, and 82.69±27.88 (p<0.001); the mean CSC scores were 52.38±21.1, 66.26±20.83, 73.9±24.14, and 76.1±25.02 (p<0.001) respectively. No serious adverse events were noted.Conclusion.Subacromial injection of HA is an effective and safe treatment for chronic shoulder pain associated with SIS.

scholarly journals Efficiency of local injections of platelet-rich plasma in shoulder impingement syndrome

2019 ◽  
Vol 13 (4) ◽  
pp. 61-65
Author(s):  
V. A. Nesterenko ◽  
A. E. Karateev ◽  
E. I. Byalik ◽  
M. A. Makarov ◽  
S. A. Makarov ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Impingement Syndrome ◽  
Shoulder Impingement Syndrome ◽  
Shoulder Impingement ◽  
Subacromial Injection ◽  
Local Injections ◽  
Promising Treatment ◽  
The Mean ◽  
Chronic Shoulder Pain

Chronic shoulder pain caused by shoulder impingement syndrome (SIS) is a common pathology that leads to worse quality of life and disability. The local administration of platelet-rich plasma (PRP) is a promising treatment for SIS.Objective: to evaluate the efficiency of subacromial injection of PRP in chronic shoulder pain caused by SIS.Patients and methods. The investigation enrolled 30 patients (13 women and 17 men; mean age, 45.8±14.1 years) with chronic shoulder pain lasting ≥3 months after rotator tendons injury confirmed by ultrasound and/or magnetic resonance imaging and inefficiency of previously medical therapy. All the patients received three subacromial injections of 5 ml of PRP at a 7-day interval. The investigators assessed the course of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at baseline and 1, 3 and 6 months after treatment.Results and discussion. During the treatment, there was a considerable improvement in all indicators. At baseline and 1 and 3 months, the mean pain severity measured on VAS was 49.3±10.3, 32.4±21.3, and 20.6±21.3 mm, respectively; in this case, the positive effect persisted at 6-month follow-up: 10 [0; 30] mm (p<0.001). The mean ASES values were 59.5±11.5, 75.9±17.4, 82.6±17.6, and 86.7±17.1 (p<0.001) and the mean CSC scores were 72.3±14.1, 81.0±16.2, 88.5±16.1, and 92.8±16.2 (p<0.001), respectively. There were no serious adverse reactions.Conclusion. Subacromial injection of PRP is an effective and safe treatment for chronic shoulder pain associated with SIS.

scholarly journals Biomechanical and Metabolic Effectiveness of an Industrial Exoskeleton for Overhead Work

2019 ◽  
Vol 16 (23) ◽  
pp. 4792 ◽  
Author(s):  
Thomas Schmalz ◽  
Jasmin Schändlinger ◽  
Marvin Schuler ◽  
Jonas Bornmann ◽  
Benjamin Schirrmeister ◽  
...  
Keyword(s):  
Heart Rate ◽  
Rotator Cuff ◽  
Musculoskeletal Disorders ◽  
Shoulder Pain ◽  
Kinematic Analysis ◽  
Shoulder Joint ◽  
Work Activities ◽  
Physiological Conditions ◽  
The Mean ◽  
Unloading Effect

Overhead work activities can lead to shoulder pain and serious musculoskeletal disorders (WMSD), such as rotator cuff injury and degeneration. Recently developed exoskeletons show promising results in supporting workers in such activities. In this study, a novel exoskeleton was investigated for two different overhead tasks with twelve participants. To investigate the effects of the device, electromyographic (EMG) signals of different shoulder and adjacent muscles as well as kinematic and metabolic parameters were analyzed with and without the exoskeleton. The mean EMG amplitude of all evaluated muscles was significantly reduced when the exoskeleton was used for the overhead tasks. This was accompanied by a reduction in both heart rate and oxygen rate. The kinematic analysis revealed small changes in the joint positions during the tasks. This study demonstrated the biomechanical and metabolic benefits of an exoskeleton designed to support overhead work activities. The results suggest improved physiological conditions and an unloading effect on the shoulder joint and muscles which are promising indicators that the exoskeleton may be a good solution to reduce shoulder WMSD among workers who carry out overhead tasks on a regular basis.

scholarly journals THU0485 THE EFFECT OF PERINEURAL INJECTION THERAPY IN PERIARTHRITIS SHOULDER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 480-481
Author(s):  
M. H. Abu-Zaid ◽  
S. A. A. Tabra ◽  
S. Elmorsy
Keyword(s):  
Rotator Cuff ◽  
Physical Function ◽  
Shoulder Pain ◽  
Adhesive Capsulitis ◽  
Injection Therapy ◽  
Perineural Injection ◽  
Group I ◽  
End Of Treatment ◽  
Significant Difference ◽  
Group Ii

Background:Primary adhesive capsulitis of the shoulder is a common pathology of the glenohumeral joint characterized by shoulder pain and progressive restriction of the range of motion,its treatment options either medication, local injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic and open capsular release1.Subcutaneous prolotherapy injections can reduce vascular endothelial growth factor levels and restore effective repair processes so induce apoptosis of proliferating peptidergic noceffectors and neovessels and inhibit TRPV1 receptors resulting to reduction of pain2,3.Objectives:To assess the effectiveness of perineural injection therapy in management of pain and physical function in Primary adhesive capsulitis of the shoulder.Methods:One hundred patients with primary adhesive capsulitis in the freezing stage were selected in this study according to the classification of Hannafin and Chiaia and had restriction of passive motion of greater than 30°in 2 or more planes of movement. Patients with previous corticosteroid injection or previous surgery in the affected shoulder, secondary adhesive capsulitis including inflammatory or infectious arthritis,previous fracture, rotator cuff lesions were excluded from this study.Ptients were randomly devided into two equal groups; Group I received 6 weekly subcutaneous injections of 0.5-1 ml of buffered dextrose 5% in each chronic constriction injury points and tender points at shoulder and along course of suprascapular, supraclavicular, axillary, musculocutanous and radial nerves. Group II received oral NSAIDs and muscle relaxants for 6 weeks. All patients in both groups received the same stretching and exercise therapy during the period of treatment. All procedures were done after informed consent. Assessments were performed at baseline, at the end of the treatment and after three and six months using visual analog scale (VAS) for pain, range of mvement measurements by goniometer, Shoulder Pain and Disability Index (SPADI) & the Western Ontario Rotator Cuff (WORC) Index.Results:Patients in Group I had more rapid relief of pain and better functional improvement compared with group II (p<0.05). There was significant improvement in both groups (p<0.05) after 3 and 6 months with significant difference between the 2 groups indicated that better results in perineural group. Results were summarized in table 1.Baseline GIBaseline GIIAfter end of treatment GIAfter end of treatment GIIAfter 3ms GIAfter 3ms GIIAfter 6ms GIAfter 6ms GIIVAS8.7±0.98.4±1.05.0±1.5*¶5.7±1.1*4.4±1.5*¶5.1±1.6*3.8±1.2*¶4.9±1.3*SPADI80.4±9.878.9±10.741.5±10.2*¶50.4±8.8*35.8±7.5*¶46.6±7.9*32.6±10.2*¶44.5±8.7*WORC28.5±10.626.5±11.560.4±9.8*¶55.9±10.5*67.9±9.7*¶57.3±10.3*71.5±12.3*¶60.1±9.6**significant improvement after treatment¶significant difference between the two studied groupsConclusion:Perineural injection therapy is an effective modality in management of pain and physical function of Primary adhesive capsulitis of the shoulder.References:[1]Franz A, Klose M, Beitzel K. Conservative treatment of frozen shoulder. Unfallchirurg. 2019;122(12):934-940.[2]Lyftogt J. Subcutaneous prolotherapy treatment of refractory knee, shoulder, and lateral elbow pain. Australasian Musculoskeletal Medicine. 2007; 12(2):110-112[3]Abu-Zaid MH, Tabra SA, Elmorsy S. FRI0687 Effect of perineural injection therapy in moderate and severe knee osteoarthritis; a comparative study. Annals of the Rheumatic Diseases 2018;77:862-863.Disclosure of Interests: :None declared

scholarly journals Subcoracoid Impingement – A Global View

2020 ◽  
Vol 26 (2) ◽  
pp. 91-94
Author(s):  
Simina-Georgiana Barbu ◽  
Alina Doina Nicoara ◽  
Daniela Elena Alistar ◽  
I.A Badea ◽  
Bojinca Mihai
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Soft Tissues ◽  
Tissue Level ◽  
Coracoid Process ◽  
Impingement Syndrome ◽  
Bony Tissue ◽  
Anatomical Anomaly ◽  
Traumatic Episode ◽  
Anterior Shoulder Pain

Abstract Modifications in joint anatomy on both soft and bony tissue level play a key role in subcoracoid impingement syndrome. The diagnostic is primarily clinical and is based on patient history and functional tests. Imaging tests support, but do not establish the diagnostic. Approach can take the form of targeted exercises with progressive load, or that of invasive surgery. Shoulder pain has a diverse etiology which derives from the complex local anatomy which includes the clavicle, acromion, coracoid process and humeral head, the soft tissues surrounding this area, in particular the rotator cuff, but can also be unrelated to all of the above and be a reflection of a pathology located in the neck, arm or trunk, or adjacent visceral organs. More often, it is the manifestation of a traumatic episode or an anatomical anomaly, or it can be secondary to inflammation, tumors, or surgery. It is the third most common musculoskeletal complaint presenting to physiotherapy, and largely impacts both an individual’s quality of life and the public health system. Coracoid impingement syndrome can present itself as a cause of rotator cuff disease, but its role is not fully established yet. It is less prevalent than subacromial impingement, can coexist with it, and therefore should be considered into the differential diagnosis of anterior shoulder pain when a patient presents themselves with activity related anterior shoulder pain.

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