Chulalongkorn Medical Journal


Objective : To study demographic data, diagnosis, treatment program andsuccess rate of rehabilitation program for shoulder pain patientand identify factors associated with more than 50% improvementof clinical symptoms.Study Design : Retrospective descriptive and case-control study.Setting Department of Rehabilitation Medicine, King ChulalongkornMemorial Hospital.Material and Method : All intra-department medical records of patients January 2004 toDecember 2007 were reviewed. Records of patients with shoulderpain who were prescribed physical therapy programs would beincluded into the study. Data related to physical therapy programsand durations of treatment were reviewed. Furthermore, their outpatientmedical data recorded by physiatrists includingdemographic data, diagnosis, underlying diseases, otherintervention, medication and the improvement of the clinicalsymptoms were also analyzed.Result : Three hundred and seventy-eight patients were included intothe study. There were 98 males (25.9%) and 280 (74.1%) females,with the mean age of 55.29 ± 12.30 years and the highest frequencyin the age category of 41-60 years old. Diabetes mellitus (26.1%)and cervical spondylosis (18.1%) were the common underlyingdiseases. Frozen shoulder or shoulder capsulitis was the mostfrequently recorded disorder (56.6%); followed by myofascial painsyndrome (15.1%), supraspinatus tendonitis (9.3%), impingementsyndrome (8.7%) and bicipital tendinitis (6.9%), respectively.The treatment programs included physical modalities (96.6%),range of motion and stretching exercise with joint mobilization(73.8%), medication (65.1%), local injection (7.4%) and dry needling(3.4%). Treatment outcomes were categorized as “resolved”(10.1%), “more than 50% improvement” (79.6%), “less than 50%improvement “ (9.3%) and “not improved” (1%). Cervical spondylosiswas the only factor that had a tendency to has a negative affect forclinical improvement (adjusted OR = 2.5 : 95% CI= 0.99 - 6.33).Conclusion : Female patients, aged from 41 to 60 years old, with underlyingdisease of diabetes mellitus had the highest prevalence of shoulderpain. More than half were diagnosed as frozen shoulder or shouldercapsulitis. Addition to physiotherapy method, the other proceduressuch as local injection and dry needling were also used. Tenpercent and ninety-percent of the patients had their symptomcompletely resolved and more than 50% improved, respectively.Cervical spondylosis has a tendency to associated with clinicalimprovement in a negative way, although it was not statisticallysignificant.


Faculty of Medicine, Chulalongkorn University

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