Comparative Study of Pain Relief in Two Non-Pharmacological Treatments in Patients with Partial Rotator Cuff Tears: A Randomized Trial

Abstract

Background Pain induction is the primary characteristic of a rotator cuff tear while muscle weakness appears as a secondary feature, leading to further disability. Objectives The study aimed to determine the effectiveness of physiotherapeutic interventions through transcutaneous electrical nerve stimulation (TENS) or microcurrent electrical nerve stimulation (MENS) in conjunction with kinesiotherapy in patients with partial thickness rotator cuff tear. Methods This was a blinded randomized prospective study. The study recruited 42 outpatients with partial rotator cuff tear under conservative treatment selected from the 401 General Military Hospital of Athens and the University General Hospital ‘Attikon’ during 2015 - 2017. Patients were assessed for pain and disability using the SPADI (shoulder pain and disability index), a numerical rating scale (NRS) for pain, and the EuroQoL-5 questionnaire for the evaluation of the quality of life. The first group received TENS and kinesiotherapy while the second group received MENS and kinesiotherapy. Three measurements were recorded. The first assessment was performed during the initial patient visit; the second after completion of the physiotherapeutic sessions, and the third one three months after the initial assessment. A follow-up ultrasound scan was performed three months after the completion of the therapeutic sessions to assess the anatomical healing of the rotator cuff tear. Results Repeated measurements analysis indicated a significant improvement in pain scores, functionality, and patients’ quality of life (P value < 0.001). Comparison of the two treatment methods did not reveal any significant differences (P value > 0.05) despite the fact that the MENS was associated with a greater improvement in pain intensity and TENS with a greater improvement in functionality and quality of life. Conclusions Using MENS and TENS appears to be equally effective in terms of pain relief, functional improvement, and quality of life enhancement in patients.

Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review

“…First, these findings underscore the importance of exercise-based conservative therapies in enhancing patient outcomes and restoring shoulder function. This hypothesis has been consolidated in recent years, as shown by the results of a recent meta-analysis, 38 which indicated that supervised physiotherapy leads to considerable improvements in pain reduction, range of motion, and shoulder function. Similarly, an RCT demonstrated the efficacy of kinesiotherapy in improving strength and functional outcomes in patients with PT-RCTs 43 .…”

“…Regarding the Level of Evidence, 5 studies were level I RCTs 30,31,34,37,38 ; 5 level III PCC studies 7,8,32,33,42 ; and 1 level IV prospective case-series study 36 …”

“…In addition, an RCT 38 compared the functional outcomes of patients treated with kinesiotherapy coupled with either transcutaneous electrical nerve stimulation or microcurrent electrical nerve stimulation. The investigation showed improvements in shoulder pain and disability assessed via the SPADI questionnaire, and in pain and overall patient’s health, determined via the EQ-5D questionnaire.…”

Role And Outcomes of Conservative Treatment in Management of Rotator Cuff Tears: A Systematic Review of Randomised Controlled Trials

“…A further 70 articles were removed based on the screening of abstracts. After screening of full texts, 17 prospective randomised controlled trials were included within this review [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. A summary of the elimination process can be found in Figure 1.…”

Physiological effects of microcurrent and its application for maximising acute responses and chronic adaptations to exercise

“…Microcurrent therapy has an unrealised potential in healing dysfunctional tissue because of its ability to mimic weak, natural bioelectric ‘injury currents’, and subsequently enhance wound repairing (Poltawski and Watson 2009 ). In addition, within the clinical setting MCT has been widely applied in patients to reduce and relieve sinus pain (Goldsobel et al 2019 ; Maul et al 2019 ), chronic scar pain and itch from skin scars (Perry et al 2010 ; Ud-Din et al 2013 ), chronic back pain (Lerner and Kirsch 1981 ), and partial rotator cuff tears related pain (Vrouva et al 2019 ).…”