acupuncture points for rotator cuff injury

88 views, 4 likes, 0 loves, 0 comments, 3 shares, Facebook Watch Videos from ITeraCare - PRIFE International Chicago: What is iTeraCare? I use local electroacupuncture treatment at acupuncture locations ("points") such at LI 14, 15, and 16; TW 14; and SI 10, 11, 12, . [1] An epidemiological study in the United States reports that 4.5 million people are hospitalized every year for Rotator cuff tears. Ongoing trials with unpublished data will also be retrieved from the following clinical trial registries: the US National Institute of Health, the NIH clinical registry Clinical Trials. It is also unlikely to work alone - it is best used in conjunction with other therapies. Improve blood flow to the tendon and muscle tissue accelerating the bodys natural tissue healing response. The patient points to the low back area on the right side. doi: 10.1002/14651858.CD012224. Acupotomy therapy for shoulder adhesive capsulitis: a systematic review and meta-analysis of randomized controlled trials. doi: 10.1097/MD.0000000000018716. J Orthop 2013;10:812. Acupressure point for shoulder pain: LI10 (large intestine meridian). Kelly SM, Wrightson PA, Meads CA. Chichester, West Sussex; Hoboken NJ: John Wiley & Sons; 2008. [5]. PRISMA flow diagram of study selection. Introduction. A systematic summary of systematic reviews on the topic of the rotator cuff. Choi, Seoyoung KMDa; Kim, Kun Hyung KMD, PhDa,b,, aDepartment of Acupuncture & Moxibustion Medicine, Pusan National University Korean Medicine Hospital. 1, 2 Most individuals with shoulder pain repeatedly visit outpatient clinic by complaining of pain even 12 months after the initial treatment. Acupuncture for Rotator Cuff Injuries Assuming you have had an MRI or a thorough orthopedic workup to rule out surgery, acupuncture can help in several ways: Relieve muscle spasms in the joint area, thereby lessening the load on the joint. neck pain There are four primary rotator cuff muscles, but the one that is most commonly injured . garlic [1-4] BOOK AN APPOINTMENT. Birch S, Lee MS, Alraek T, et al. They can occur from dysfunctional movements in the shoulder blade and arm that lead to wear and tear over time in the rotator cuff eventually causing a tear. PRISMA = the preferred reporting items for systematic reviews and meta-analyses. Other causes include aging and weakening of the tendons and injuries to the shoulder. A trial that is rated as high risk of bias in 1 or more aspects will be graded as high risk, while a low risk of bias in all aspects will be graded as low risk. Cochrane Database Syst Rev 2019;10:ED000142. This article focuses on alternative . These muscles work together to stabilize the joint, rotate the shoulder and move the arm. Managements of rotator cuff disease often include acupuncture and manual therapy, usually delivered together. We define a definite diagnosis as a diagnosis of RCD that has been confirmed by both clinical assessments and diagnostic imaging (e.g., ultrasound, magnetic resonance imaging). Two very effective ways of remedying the rotator cuff are acupuncture and guasha. 2020 Jan;99(2):e18716. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.md-journal.com). [13]. When acupuncture was provided along with other active treatments for the acupuncture group, the same active treatment had to be given to control groups in order for the trial to be included. Project administration: Seoyoung Choi, Kun Hyung Kim. Injuries range from acute strains, swelling and bruising, to chronic inflammation and fibrotic thickening and weakening of the rotator cuff tendon. The supraspinatus, often affected by bone spurs, is one of the most common to experience either of these types of tears. Keyword Highlighting If trials include a mixed population with shoulder diseases including RCD, we will try to retrieve the data for patients with RCD. doi: 10.1136/bmjopen-2016-015461. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the overall quality of the evidence for each main outcome with respect to the following domains: the risk of bias across studies, directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias. Be used in conjunction with an ongoing rehabilitation program, You have significant weakness and loss of function in your shoulder, Your tear was caused by a recent, acute injury. Tang H, Fan H, Luo F, Huang L, Liao S, Yu W, Chen Y, Chen J, Qin X. hormones Shoulder pain or omalgia is one of the main types of osteoarticular pain that can be observed in every-day clinical practice and it is considered the third most common osteomuscular cause of medical consultation. We will use funnel plots to evaluate reporting bias if we retrieve a minimum of 10 trials reporting the same outcome. We will search the EMBASE, the Cochrane Library, Ovid MEDLINE, PubMed, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Wanfang Database, the Chongqing VIP, the US National Institute of Health, the NIH clinical registry Clinical Trials, the International Clinical Trials Registry Platform, the Australian New Zealand Clinical Trials Registry and the Chinese clinical registry, from their inception to April 1, 2020. Some error has occurred while processing your request. Patients with a provisional diagnosis of RCD include patients who are assumed to have RCD based solely on history taking and physical examinations without radiological assessment. blood sugar In addition to the needles from acupuncture, moxibustion can also be used which may hasten recovery. Acupuncture for treating acute ankle sprains in adults. There is evidence that supports the effectiveness and safety of acupuncture for chronic musculoskeletal conditions, including shoulder pain. One-year outcome of subacromial corticosteroid injection compared with manual physical therapy for the management of the unilateral shoulder impingement syndrome: a pragmatic randomized trial. Cervical nerve root impingement, typically from disc herniation or arthritis in the neck. Treatment for this disorder consist of 12 treatments for six weeks. Your rotator cuff allows you to lift your arms and reach upward. Get new journal Tables of Contents sent right to your email inbox, http://creativecommons.org/licenses/by/4.0, MD_2020_04_30_CHEN_MD-D-20-03478_SDC1.docx; [Word] (14 KB), Acupuncture and manual therapy for rotator cuff tears: A protocol for systematic review and meta analysis, Articles in PubMed by Hongzhi Tang, MD, PhD, Articles in Google Scholar by Hongzhi Tang, MD, PhD, Other articles in this journal by Hongzhi Tang, MD, PhD, The efficacy of Tai Chi for depression: A protocol for systematic review and meta-analysis, The comparative effectiveness of traditional Chinese medicine exercise therapies in elderly people with mild cognitive impairment: A protocol for a network meta-analysis, Discrimination between pain and contracture in limited passive motion patients with rotator cuff tear: A STROBE-compliant cross-sectional study, Arthroscopic labral debridement versus labral repair for patients with femoroacetabular impingement: A meta-analysis, Effectiveness of supervised early exercise program in patients with arthroscopic rotator cuff repair: Study protocol clinical trial, Privacy Policy (Updated December 15, 2022). [7] Acupuncture is under consideration as a technique to be applied in Western medical practice for a great many complaints, especially for cases in which modern techniques are either of limited effectiveness or are unsuitable. This acupressure point is great for everything involving your head. Dry needling is a modern treatment designed to ease muscular pain. An official website of the United States government. cortisol Korean Medicine, including acupuncture and pharmacopuncture, is a part of conservative . Tang, Hongzhi MD, PhDa; Luo, Fei MBa; Fan, Huaying MDb; Huang, Li MBa; Liao, Shichuan MBa; Yu, Wenjing MMa; Chen, Yunbei MMa; Qin, Xuefei MMa,; Chen, Jiao MD, PhDb,, aOutpatient department of Sichuan orthopedic hospital. food allergies depression Rotator cuff tears is one of the common musculoskeletal complaints, and significantly impacts a person's health-related quality of life. Wolters Kluwer Health HHS Vulnerability Disclosure, Help A random effects model will be used to calculate the pooled effect estimates, because substantial clinical heterogeneity is expected among the studies included in this review. Prospective registration of this study was approved by the Open Science Framework (OSF) registries (osf.io/n2e6t), and the protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines[13]. Rotator cuff tears do not only happen during athletic activities. Fortunately, there are number of resources out, Read More 4 Ways to a Better Nights SleepContinue, acupuncture Step 1: Identify the "sick" meridian. Press gently, just above the elbow, to stretch the shoulder. stress Socially-distant therapeutic exercise classes coming soon? [6] Manual therapy is also commonly used in the management of rotator cuff tears. After removing duplicates, they will then use the full-text articles to determine which papers will finally be included in the review. The intrinsic theory describes degeneration in the rotator cuff tendon itself as a primary cause, leading to impingement and a loss of structural integrity. We will exclude studies that only compare different forms or methods of acupuncture (eg, transcutaneous electrical nerve stimulation) and compare acupuncture with any complementary and alternative therapies for which the efficacy is not yet established (eg, Chinese herbs). Device: Acupuncture. Ann Intern Med 2014;161:1619. 2016 Jun 10;2016(6):CD012224. Bladder 2, on the face, along the eyebrow, where the eyebrow meets the nose. The Rotator Cuff (RC) is a common name for the group of 4 distinct muscles and their tendons, which provide strength and stability during motion to the shoulder complex. Those are three of the, Symptoms are trying to tell you something. Its incidence increases with age . [14]. cbd Local acupoints chosen for this treatment are Jianyu . -, Rhon DI, Boyles RB, Cleland JA. Results of the quality assessment and rationale for the decisions will be presented in risk of bias tables, and will be used for grading the overall quality of evidence for each outcome. In this procedure, surgeons insert a tiny camera (arthroscope) and tools through small incisions to reattach the torn tendon to the bone. [15]. The objective of this systematic review is to evaluate the effectiveness and safety of acupuncture for managing symptoms in patients with RCD. Conceptualization: Seoyoung Choi, Kun Hyung Kim. Ethical approval is not necessary as this review will not require data from individual patients. Fluctuations in your hormones, such as dropping estrogen levels, can result in symptoms such as night sweats, insomnia, hot, Read More Perimenopause Causes Pain: Acupuncture Can HelpContinue, According to the National Institute of Healthit is estimated that some 50-70 million Americans suffer from sleep or wakefulness disorders causing nearly $50B in lost productivity and upwards of 5000 car crashes. [2,6], The extrinsic theory hypothesizes that pressure damage occurs due to pathological contact between the rotator cuff and the acromion while lifting the arm. We will exclude trials for patients having shoulder or arm pain due to systemic inflammatory conditions such as rheumatoid arthritis, fractures, adhesive capsulitis, osteoarthritis, hemiplegic shoulders, or myofascial pain of the upper extremity. dietary supplements The following information will be extracted: study characteristics (e.g., design, authors, date of publication, country, language, sample size), participants (e.g., age, gender, severity of symptoms at baseline), acupuncture and control intervention (e.g., number of sessions, duration, acupuncture points), outcome measures, results of intervention, duration of follow-up assessments, funding, conflict of interest, and reported adverse effects. Minagawa H, Yamamoto N, Abe H, et al. Please enable scripts and reload this page. [Electro-acupuncture promotes repair of rotator cuff injury in rats]. gan mao ling We define that an I2 of less than 40% is low, 30% to 60% is moderate, 50% to 90% is substantial, and 75% to 100% is considerable.[14]. Acupuncture for rotator cuff injuries is a safe, noninvasive . Acupuncture for symptomatic rotator cuff disease: Protocol for a systematic review and meta-analysis. Two review authors will independently screen for titles and abstracts. 6. Control interventions will include active treatments (e.g., oral medication, glucocorticoid injection, electrotherapy, manual therapy, or exercise), waiting list control or placebo treatment. back pain Electrotherapy modalities for. Writing review & editing: Kun Hyung Kim. Shoulder pain is the third most common specific reason U.S. patients seek acupuncture treatment. Swelling of the bursa and thickening of the rotator cuff can push the tendon up into the bony arch of the scapular acromion, creating a vicious cycle of tendon injury that can eventually lead to complete tears of the rotator cuff. 1. Trigger point acupuncture can be an effective way to release the infraspinatus muscle and improve your movement. 2020;99:2(e18716). Background: The tears of rotator cuff is caused by the tears or aseptic inflammation of tendon tissue such as subscapular muscle, supraspinatus muscle, infraspinatus muscle, teres minor muscle, and so on, which make up the rotator cuff. Rotator cuff tear (RCT) is one of the main causes of shoulder pain and dysfunction. Proportion of patients who finally ended up receiving shoulder surgery. Open Science Framework Preregistration. If the missing data were not obtained, we will analyze only the available data. Dichotomous outcomes will be presented as risk ratios (RR), and continuous outcomes will be presented as weighted or standardized mean differences (SMD). Please try after some time. Dr. Jeremy B. Steiner reveals the Best Electro-Acupuncture Strategy for Shoulder Pain & Dysfunction. Herbal supplements can d, http://orthoinfo.aaos.org/topic.cfm?topic=a00406, Just a Few Sessions: You Can Dip In (and Out) of Acupuncture. We will exclude trials that include any participants with a history of significant trauma or systemic inflammatory conditions such as rheumatoid arthritis, osteoarthritis, hemiplegic shoulders, or pain in the shoulder region as part of a complex myofascial neck/shoulder/arm pain condition. J Clin Epidemiol 2011;64:3802. Highlight selected keywords in the article text. Trigger point needling is especially effective in reducing pain caused by a rotator cuff injury. Effects of dry needling trigger point therapy in the shoulder region on patients with upper extremity pain and dysfunction: a, [13]. Another recent study of acupuncture for shoulder impingement syndrome in Family Practice found benefits comparable to cortico-steroid injection. BMJ Open. Manual therapy and exercise for rotator cuff disease. circadian rhythm Dry needling works by eliciting a twitch response in the muscle, which relaxes it and decreases pain. Pain intensity measured on validated scales, such as the visual analogue scale (VAS) or numeric rating scale (NRS), within 12 weeks. Randomized controlled trials that include patients with rotator cuff tears receiving acupuncture and manual therapy versus a control group will be included. Rotator cuff injury is the degeneration and tear of the rotator cuff muscle at the stop point of the humerus. Acupuncture for symptomatic rotator cuff disease: Protocol for a systematic review and meta-analysis. Evidence quality will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. How to cite this article: Choi S, Kim KH. more relief for rotator cuff injuries than . Vickers AJ, Vertosick EA, Lewith G, et al. [1]. Acupoint-related interventions that do not penetrate the skin with needles (e.g., moxibustion, acupressure, or laser acupuncture) will be excluded. men's health Arthritis Rheum 1991;34:7669. The needles were applied to the area of the injured shoulder while the patient was lying in a lateral decubitus position on the stretcher. Acute tears are typically traumatic in nature and result from a fall with an outstretched arm are lifting something too heavy. Registration: Open Science Framework (OSF) Preregistration. We will extract details of the acupuncture treatment and control interventions on the basis of the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). migraine [14] Level of evidence will be classified into 4 categories: high, moderate, low, or very low. Prospective registration of this study has been approved by the Open Science Framework registries (https://osf.io/registries) with a registration number 10.17605/OSF.IO/M3NKV, and the protocol has been written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement guidelines.[13]. sleep It helps restore health to your eyes, ears, nose, and throat. Consequently, we decided to conduct a systematic review based on the best currently available evidence and methodology to evaluate whether acupuncture and manual therapy is effect and safety for pain and function of rotator cuff tears. [14]. We will use Rev Man software (Review Manager Version 5.3 for Windows, The Nordic Cochrane Centre, Copenhagen) to carry out statistical analysis. We will exclude other methods of stimulating acupuncture points without needle insertion (such as laser stimulation or transcutaneous electrical stimulation). Supplemental digital content is available for this article. Treatment is aimed at stopping pain, decreasing inflammation, and restoring range-of-motion and strength by moving qi and blood, clearing heat and obstruction, and draining dampness from the shoulder region. Quality assessment will be performed using the Cochrane risk of bias tool. PMC Rotator cuff pain can be caused by playing sports that involve throwing or overhead reaching, such as baseball and swimming. Discussion: Santa Cruz Acupuncture Orthopedics and Sports Medicine Clinic, Acupuncture for Pain and Injuries in Santa Cruz, Scotts Valley, San Lorenzo Valley, Capitola since 2003, Acupuncture treatment of rotator cuff tendonitis, Evidence basis for acupuncture for rotator cuff tendonitis, My clinical experience with acupuncture for shoulder pain, Self-care and exercise for rotator cuff tendonitis, Risks of delayed or non-treatment of rotator cuff tendonitis, largest study of acupuncture treatment of shoulder pain, recent study of acupuncture for shoulder impingement syndrome, Acupuncture Orthopedics and Sports Medicine. PRISMA flow diagram of study selection. Methods: The detailed process of study selection will be shown in a PRISMA flow diagram (Fig. If there is more than 1 outcome measurement in the same time frame, we will extract the last measurement data within the time frame. Acupuncture Points Used for Rotator Cuff Tendinitis. Dry needling is a therapeutic technique that involves inserting thin needles into the skin and underlying tissues to release trigger points, improve muscular pain and dysfunction, and promote tissue healing. Multiple treatment groups in a trial will be combined into a single pairwise comparison. I list them below. In general, I find that rotator cuff injuries respond very well to acupuncture, with full recovery possible in many cases. Crossword; Sudoku; Crossword; Sudoku; Obituaries Acupoint-related interventions that do not penetrate the skin with needles (e.g., moxibustion, acupressure, or laser acupuncture) will be excluded. The updated evidence that would be provided by this review will offer useful information for patients and practitioners, and also have implications for future studies and the development of clinical practice guidelines of RCD. Trigger point needling is especially effective in the treatment of rotator cuff injuries as it helps to release knots within the muscle fibers, ultimately reducing pain and increasing blood flow to the area. A wide range of acupuncture techniques as they are currently practiced was not fully reflected in the scope of the previous evidence, which implies an evidence-practice gap to be covered. cancer There are no limitations on the methods of stimulation (e.g., electro-acupuncture, pharmacopuncture, thread-embedding therapy, acupotomy), points of stimulation (e.g., auricular points, scalp acupuncture points, tender points), types of needle, duration of treatment, or number of treatments. Symptoms can include weakness in the arm and throbbing pain while sleeping. Games, Puzzles, and Crossword. Untreated or under-treated rotator cuff impingement can lead to complete tears of the rotator cuff, shoulder joint degeneration (arthritis), frozen shoulder, and neck and arm pain. The relative safety of acupuncture for shoulder pain makes it worthy of trying in almost all cases. The needles were perpendicularly inserted to a depth of 2-3 cm. Postural correction with scapular stabilization exercises, kinesiotaping and ergonomic modifications are often important to correct the underlying faulty biomechanics that put the shoulder at risk of injury. The search terms consist of 2 parts: rotator cuff disease (e.g., rotator cuff, impingement, subacromial) and acupuncture (e.g., acupuncture, electroacupuncture, needling, pharmacopuncture, embedding therapy, acupotomy). immunity This work was supported by the NSFC (Natural Science Foundation of China) (grant number 81804203), Sichuan Science and Technology Program (grant number 2015SZ0096), and Chengdu University of Traditional Chinese Medicine Science and Technology Development Fund (grant number YYZX1619). Shamseer L, Moher D, Clarke M, et al. Crossover randomized trials, if any, will be included, but only the pre-crossover data will be analyzed in order to avoid carryover effects. Arthritis Rheum 1991;34:7669. This systematic review would provide updated evidence of various types of acupuncture that specifically focuses on its effectiveness and safety for patients with RCDs. Evidence quality will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. LF and CYB will screen full copies of the remaining studies after the title and abstract selection. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. The quality of evidence of a specific study will be assessed according to the risk of bias, inconsistency, indirectness, imprecision, publication bias, large effect, dose-response, and all plausible confounding. to maintaining your privacy and will not share your personal information without Subacromial impingement syndrome: management challenges. Combinations of Medical Subject Headings (MeSH) and text words will be used. Both. There are 2 main causes of rotator cuff tears: injury and degeneration. True Frozen Shoulder can also respond poorly to conservative therapies; however some cases mis-diagnosed as Frozen Shoulder are actually rotator cuff impingement and can be treated successfully with acupuncture. On the back of the body, there are . RCT = randomized controlled trial, RCD =, [1]. The kin, Having trouble sleeping? FHY and HL will extract information from the included studies and enter into the electronic database. Shoulder pain is described in Traditional Chinese Medicine as stagnation or obstruction of the flow of qi and blood in the tendons and muscles of the Large Intestine, Small Intestine, and Internal Membrane acupuncture meridians. Glazier RH, Dalby DM, Badley EM, et al. One common shoulder injury is a rotator cuff tear. All the authors drafted and revised this study protocol and approved it for publication. It correlates pretty well with the gluteus medius and gluteus minimus muscle trigger points. Minagawa H, Yamamoto N, Abe H, et al. Work disability, such as length or total days of sick leave. The authors have no conflicts of interest to disclose. Medicine (Baltimore). Orthop Res Rev 2018;10:8391. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. If there is a low or unclear risk of bias for all main aspects, the trial will be rated as unclear risk. The aims of both types of interventions are to improve function, promote healing, increase joint range, strengthen weakened muscles and correct imbalance in the stabilizing function of the rotator cuff. Active range of motion of shoulder joint. See this image and copyright information in PMC. We will try to contact the original investigators by email to request missing data. Open tendon repair. Useful but incomplete data will be obtained for data synthesis from the contact trial researcher. Pain at night when resting on the affected side. immune system Thread embedding acupuncture for musculoskeletal pain: a systematic review and meta-analysis protocol. Rotator cuff diseases (RCDs) are the most common underlying cause of shoulder pain, with estimates of prevalence ranging from 65% to 85% depending on the context and characteristics of the study population. The treatment principle of rotator cuff tears is to reduce pain and improve the function of shoulder joint. Rotator cuff tendinitis is an injury that plagues athletes and non-athletes alike. [9,11,12] Methodological limitations of previous reviews, including the exclusion of studies that had reported their findings in languages other than English[12] or failure to register their reviews,[9] also calls for systematic reviews addressing such problems. insomnia For each item, risk of bias will be graded as high, low, or unclear. Correspondence: Kun Hyung Kim, Pusan National University Korean Medicine Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan 50612, Republic of Korea (e-mail: [emailprotected]). to maintaining your privacy and will not share your personal information without The research shows that acupuncture can promote the release of -endorphin[10] and increase the concentration of 5-hydroxytryptamine in brain tissue,[11] so as to reduce the sensitivity of tissue to pain and improve joint activity. PRISMA flow diagram of study selection. [10] However, previous systematic reviews of acupuncture for shoulder pain included heterogeneous shoulder disorders that might respond to given treatments differently based on the underlying pathophysiology, and these reviews did not completely address the role of acupuncture in the management of RCDs. Management of common musculoskeletal problems: a survey of Ontario primary care physicians. I believe this is because the shoulder is mostly composed of muscles and tendons, and . For more information, please refer to our Privacy Policy. In addition, it may help reduce muscle soreness during workouts. Many cases of rotator cuff tear surgery may have been able to be prevented with the use of acupuncture. [16]. Open Science Framework Preregistration. [17] In addition, the increasing use of acupuncture and manual therapy around the world has not been mentioned in previous reviews, which means that clinical trials and systematic reviews are necessary to assess the effectiveness and safety of such interventions in patients with pain and dysfunction caused by rotator cuff tears. Distance consults available during Coronavirus. Evid Based Complement Alternat Med 2019;2019:2010816. The dichotomous data will be presented as risk ratios with 95% CIs and the continuous data will be presented as weighted mean differences or standardized mean differences with 95% CIs. We will contact the authors in China via telephone, and authors from elsewhere via email to obtain missing data, if necessary. Classifications are as follows: We will perform sensitivity analyses to determine whether the results have been influenced by trials where radiologic diagnosis of RCDs was not mentioned in the participant eligibility criteria, where measures of variance are missing, and where different methods of analysis were used (random-effects model or fixed-effect model). [2] The rotator cuff is composed of supraspinatus muscle, infraspinatus muscle, subscapularis muscle and teres minor muscle. Kim TH, Lee MS, Kim KH, Kang JW, Choi TY, Ernst E. Cochrane Database Syst Rev. Jumpers knee? Rotator cuff tendonitis, bursitis and impingement are common causes of shoulder pain, particularly in middle-aged patients. Your message has been successfully sent to your colleague. [2,3] Subacromial pain syndrome is a comprehensive term, that describes non-traumatic shoulder problems with subacromial pain during abduction of the arm. Ethics and dissemination: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. IntroductionShoulder pain is one of the most common musculoskeletal disorders among adults and is caused by a variety of shoulder conditions. 1) The supraspinatus. CMAJ 1998;158:103740. Happily, that trend seems to be changing. Please try again soon. Background: Shoulder pain is a common musculoskeletal disorder. The mechanisms of. Medicine. CMAJ 1998;158:103740. liver qi stagnation We define that an I2 of less than 40% is low, 30% to 60% is moderate, 50% to 90% is substantial, and 75% to 100% is considerable.[14].

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