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J Acupunct Res > Volume 32(4); 2015 > Article
Lee, Suk, Ryu, Lee, Kim, Ryoo, Goo, Kim, Park, Seo, and Baek: Analysis of Treatment Outcomes for Idiopathic and Secondary Frozen Shoulder with Traditional Korean Medicine: A Retrospective Study

Abstract

Objectives:

This study was performed to analyze treatment outcomes of idiopathic and secondary frozen shoulder patients with clinical characteristics as well as percentage of pain reduction, and to find out relevant factors for pain reduction in the frozen shoulders of each patient group.

Methods:

Data were collected from outpatients who visited the Acupuncture and Moxibustion department and treated with traditional Korean Medical treatments at a Korean Medicine Hospital from June 12, 2006 to June 30, 2015. Patients were divided into two groups; idiopathic and secondary frozen shoulder, based on imaging and medical records. Clinical characteristics (demographic characteristics, disease characteristics, treatment characteristics) and percentage pain reduction were collected. Percentage pain reduction was compared between two groups and relevant factors for pain reduction were analyzed.

Results:

78 outpatients’ medical records were reviewed. There was no significant difference of clinical characteristics between idiopathic and secondary frozen shoulder patients In percentage pain reduction, there was no significant difference between the two groups. In the idiopathic frozen shoulder group, patients who had a short duration from the onset had a tendency for less pain (p<0.05). In the secondary frozen shoulder group, patients taking herbal medicine experienced significantly less pain (p<0.05).

Conclusions:

We could find no significant difference in percentage pain reduction with traditional Korean medicine between idiopathic and secondary frozen shoulder. Duration from the onset could be relevant in percentage pain reduction in idiopathic frozen shoulder, and taking herbal medicine could be relevant in the percentage pain reduction in secondary frozen shoulder.

Fig. 1
Flow chart
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Table 1
Classification of Frozen shoulder
Primary/idiopathic Frozen shoulder
An underlying etiology or associated condition cannot be identified
Secondary Frozen shoulder
An underlying etiology or associated condition can be identified
Intrinsic In association with rotator cuff disorders (tendinitis and partial-thickness or full-thickness tears), biceps tendinitis, or calcific tendinitis
Extrinsic In association with previous ipsilateral breast surgery, cervical radiculopathy, chest wall tumor, previous cerebrovascular accident, or more local extrinsic problems, including previous humeral shaft fracture, scapulothoracic abnormalities, acromioclavicular arthritis, or clavicle fracture
Systemic Diabetes mellitus, hyperthyroidism, hypothyroidism, hypoadrenalism, etc.
Table 2
Clinical characteristics of the idiopathic and secondary Frozen shoulder groups
Characteristics Idiopathic group
(n=40)
Secondary group
(n=38)
p-value
Age(years) 54.90±10.74 55.29±8.11 0.858
Sex Male 17 (42.5) 15 (39.5) 0.786
Female 23 (57.5) 23 (60.5)
Occupation Deskwork 7 (17.5) 9 (23.7) 0.653
Manual 7 (17.5) 8 (21.1)
Retired 8 (20.0) 4 (10.5)
Housewives 18 (45.0) 17 (44.7)
Lesion Left 17 (42.5) 14 (36.8) 0.616
Right 21 (55.3) 21 (55.3)
Both 3 (7.9) 3 (7.9)
Duration (month) 6.56±6.86 6.31±6.63 0.870
Radiating pain pain 19 (47.5) 10 (26.3) 0.053
no-pain 21 (52.5) 28 (73.7)
Night pain pain 27 (67.5) 27 (71.1) 0.734
no-pain 13 (32.5) 11 (28.9)
Session (times) Weekly 1.54±0.60 1.66±0.58 0.36
Total 10.43±6.89 11.42±7.89 0.554
Herbal medicine With 29 (72.5) 26 (68.4) 0.693
Without 11 (27.5) 12 (31.6)
West-medical treatment With 29 (72.5) 23 (60.5) 0.367
Without 11 (27.5) 15 (39.5)
Home exercise With 25 (62.5) 20 (52.6) 0.367
Without 15 (37.5) 18 (47.4)

Values expressed as mean±S.D, or percent.

Table 3
Number of patients with secondary Frozen shoulder
Classification N
Intrinsic Supraspinatus tendinitis 13
Infraspinatus tendinitis 1
Bicipital tenosynovitis 11
Calcific tendinitis 1
Rotator cuff tear 9
Extrinsic Cevical radiculopathy 2
Ulnar fracture 1
Systemic Diabetes Mellitus 11
Cancer 2
Hypothyroidism 1
Table 4
Comparison of percentage pain reduction between Idiopathic and Secondary group
Idiopathic group
(n=40)
Secondary group
(n=38)
p-value
Pain Reduction (%) 50.00±37.07 49.47±37.34 0.95

Values expressed as mean±S.D

Table 5
Relevance between percentage pain reduction and each clinical characteristic in idiopathic frozen shoulder
Pain reduction
r or mean±S.D p-value
Age1) −0.026 0.872
Sex2) Male 50.00±37.58 0.933
Female 50.00±37.54
Occupation3) Deskwork 47.14±41.12 0.806
Manual 38.57±33.88
Retired 56.25±39.62
Housewives 52.78±37.70
Lesion3) Left 54.71±35.90 0.429
Right 51.11 ±37.08
Both 30.00±42.43
Duration1) −0.331 0.037*
Radiating pain2) pain 49.47±38.80 0.978
no-pain 50.48±36.40
Night pain2) pain 58.15±38.43 0.057
no-pain 33.08±28.40
Session (Weekly)1) 0.070 0.667
Session (Total)1) 0.226 0.161
Herbal medicine2) with 47.59±36.90 0.400
without 56.36±38.54
West-medical treatment2) with 38.62±39.98 0.685
without 53.64±29.42
Home exercise2) with 47.20±35.88 0.952
without 52.14±40.03

Statistical significance test was done by Pearson correlation coefficient.

Statistical significance test was done by Mann-Whitney test.

§ Statistical significance test was done by ANOVA.

* Correlation is significant at the 0.05 level (2-tailed).

Table 6
Relevance between percentage pain reduction and each clinical characteristic in secondary frozen shoulder
Pain reduction
r or mean±S.D p-value
Age1) −0.110 0.511
Sex2) Male 5.33±34.11 0.161
Female 43.04±38.67
Occupation3) Deskwork 61.11±37.56 0.103
Manual 65.00±40.71
Retired 62.50±38.62
Housewives 32.94±31.38
Lesion3) Left 40.00±35.95 0.333
Right 57.62±38.72
Both 36.67±28.87
Duration1) −0.221 0.182
Radiating pain2) pain 51.00±32.47 0.800
no-pain 48.93±39.47
Night pain2) pain 49.26±37.51 0.935
no-pain 50.00±38.73
Session (Weekly)1) −0.112 0.502
Session (Total)1) 0.134 0.423
Herbal medicine2) with 59.62±37.15 0.015*
without 27.50±28.00
West-medical treatment2) with 53.04±37.23 0.544
without 47.14±37.50
Home exercise2) with 50.00±34.49 0.846
without 48.89±41.29

Statistical significance test was done by Pearson correlation coefficient.

Statistical significance test was done by Mann-Whitney test.

§ Statistical significance test was done by ANOVA.

* Correlation is significant at the 0.05 level (2-tailed).

VI.
VI.

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