Conservative treatment can reduce the rate of arthroscopic subacromial decompression surgery: A Randomized Control Trial
Abstract
OBJECTIVE: To relieve symptoms of subacromial pain syndrome, and associated upper limb functional limitations to reduce the need for arthroscopic subacromial decompression surgery for grade I, IItendinopathy by using a well-developed conservative treatment
plan.
METHODOLOGY: A randomized control clinical trial was performed on 100 patients suffering from subacromial pain syndrome in November 2020. Patients with failed previous pharmacological treatment and interest for subacromial decompression surgery were screened and selected after filling inclusion criteria (long-standing shoulder pain due to grade I, II supraspinatus tendon calcification diagnosed on radiograph, and upper limb functional limitation), randomly divided into two groups, the intervention group(n=50), and control group (n=50). The patients in the intervention group received moist-heat for 10 minutes, and isometric exercises, non-steroidal anti-inflammatory drugs twice a day for 12 weeks, then progressive resistance exercises along with medicine up to 24 weeks. The patients in the control group received routine medication or continued conventional remedies. The intensity of pain was measured by
a numeric rating pain scale, and upper limb functional activities were measured by the disability of arm, shoulder, and hand index before and after treatment.
RESULTS: Disability of arm, shoulder, and hand index score showed a significant improvement in upper limb functional activities (<0.05) in the intervention group after 12 and 24 weeks. Similarly, a significant improvement in pain intensity was observed in the intervention group (<0.05) after treatment compared to the control group.
CONCLUSION: It was concluded that conservative treatment reduced shoulder pain, upper limb disabilities by improving upper limb functional capacity in subacromial pain syndrome patients.
KEYWORDS: Subacromial pain syndrome, Arthroscopic subacromial decompression surgery, arms shoulder and hand disability index, Pain rating scale
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