오십견 환자의 치료에 있어서 저주파자극기의 효과

Efficacy of Low Frequency Stimulator in Patients with Frozen Shoulder

  • 임윤희 (분당서울대학교병원 마취통증의학과) ;
  • 이평복 (분당서울대학교병원 마취통증의학과) ;
  • 서명신 (분당서울대학교병원 마취통증의학과) ;
  • 박상현 (분당서울대학교병원 마취통증의학과) ;
  • 오용석 (분당서울대학교병원 마취통증의학과) ;
  • 박지현 (한림대학교 의과대학 마취통증의학과)
  • Lim, Yun Hee (Department of Anesthesiology and Pain Medicine, Seoul National Bundang Hospital) ;
  • Lee, Pyung Bok (Department of Anesthesiology and Pain Medicine, Seoul National Bundang Hospital) ;
  • Seo, Myung Sin (Department of Anesthesiology and Pain Medicine, Seoul National Bundang Hospital) ;
  • Park, Sang Hyun (Department of Anesthesiology and Pain Medicine, Seoul National Bundang Hospital) ;
  • Oh, Yong Seok (Department of Anesthesiology and Pain Medicine, Seoul National Bundang Hospital) ;
  • Park, Ji Hyun (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallyum University)
  • 투고 : 2005.09.20
  • 심사 : 2005.12.06
  • 발행 : 2005.12.10

초록

Background: Frozen shoulder is not an uncommon disease, which is associated with chronic pain and joint movement limitation. However, there are numerous devices to assist in the treatment of shoulder pain, but their efficacy has not been proven and their use remains immensely controversial. Therefore, a randomized clinical study was conducted to determine the effectiveness of a low-frequency stimulator for the treatment of frozen shoulder. Methods: A randomized clinical trial was carried out on 40 patients with frozen shoulder, with 40 patients assigned to two groups; a control treatment group (group C, n = 20) and a low frequency stimulator application group (group T, n = 20). Both groups were given a routine treatment modality, such as trigger point injection, intramuscular stimulation or suprascapular nerve block etc. The level of the shoulder pain was evaluated using a 100mm VAS (visual analog scale) at each visit, with the limitation in the range of motion simultaneously evaluated. Results: All the subjects improved after treatment, with the VAS scores after termination of treatment showed a statistically significant reduction (P < 0.05). However, there was no significant difference between the two groups. One month after termination of 5 cycles of treatment, group T maintained their improved state, whereas the pain in some of those in group C reemerged, which also showed a statistically significant difference (P < 0.05). The limitation in the range of motion improved, with most subjects able to resume daily activity. Conclusions: Although the low frequency stimulation provided no more pain relief than routine treatment, the effect was significantly prolonged. From this result, low frequency stimulation can be considered to aide the therapeutic effect of classical frozen shoulder therapy.

키워드

참고문헌

  1. Wall Pl), Sweet WH: Temporary abolition of pain in man. Science 1967; 155: 108-9.
  2. Shin KM, Hong SY, Choi YR: Electric stimularion for pain relief using acupuncture needles. Korean J Pain 1992; 5: 52-6.
  3. Kim HK, Kim SH, Kim MJ, Lim JA, Kang PS, Woo NS, et al: Intramuscular stimulation in chronic pain patients. Korean J Pain 2002; 15: 139-45.
  4. Melzack R, Wall P: Pain mechanisms: a new theory. Science 1965; 150: 971-8.
  5. Eriksson MB, Sjolund BH, Nielzen S: Long term results of peripheral conditioning stimulation as an analgesic measure in chronic pain. Pain 1979; 6: 335-47.
  6. Maillefert JF, Eicher JC, Walker P, Dulieu V, Rouhier-Marcer I, Branly F, et al: Effects of low-frequency electrical srimulation of Quadriceps and calf muscles in parients with chronic heart failure. J Cardiopulm Rehabil 1998; 18: 277-82.
  7. Choi JR: A novel approach ro rhe treatment of shoulder pain. Korean J Pain 1991; 4: 168-78.
  8. Binder A, Hazleman BL, Parr G, Roberts S: A controlled study of oral prednisolone in frozen shoulder. BrJ Rheumatol 1986; 25: 28892.
  9. The Korean Pain Society: Pain medicine. 2nd ed. Seoul, Koonja Publishing Inc. 2000, pp 118-20.
  10. Gunn CC, Milbrandt WE, Little AS, Mason KE: Dry needling of muscle motor points for chronic low back pain: a randomized clinical trial with long-term follow-up. Spine 1980; 5: 279-91.
  11. Cotter DJ: Overview of transcutaneous nerve stimulation for treatment of acute postoperative pain. Med Instrum 1983; 17: 289.
  12. Budsen P, Ericson K, Peterson LE, Thiringer K: Pain relief in labor by transcutaneous electrical nerve stimulation. Testing of a modificated stimulation technique and elevation of the neurological and biochemical condition of the newborn infant. Acta Obstet Gynecol Scand 1982; 61: 129-36.
  13. Lee SH, Kim SK, Woo NS, Lee YC, Chang SK, Kim SB: The effect of acupunctute-like TENS on finger control gate: Patients with cervical sprain and postoperative pain of laminectomy. Korean J Pain 1996; 9: 140-4.
  14. Thomas M, Lundberg T: Importance of modes of acupuncture in the rrearment of chronic nociceptive low back pain. Acta Anesthesiol Scand 1994; 38: 63-9.
  15. Hughes GS Jr, Lichstein PR, Whitlock D, Harker C: Response of plasma beta-endorphins to transcutaneous electrical nerve stimulation in healthy subjects. Phys Ther 1984; 64: 1062-6.
  16. Sluka KA, Deacon M, Stibal A, Strissel S, Terpstra A: Spinal blockade of opioid receptors prevents the analgesia produced by TENS in arthritic rats. J Pharmacol Exp Ther 1999; 289: 840-6.
  17. Sjlund BH, Ericksson MB: The influence of naloxone on analgesia produced by peripheral conditioning stimulation. Brain Res 1979; 173: 295-301.
  18. Yoshida N, Sairyo K, Sasa T, Fukunaga M, Koga K, Ikata T, et al: Electrical stimulation prevents deterioration of the oxidative capacity of disuse-atrophied muscles in rats. Aviar Space Environ Med 2003; 74: 207-11.
  19. Gould N, Donnerrneyer D, Pope M, Ashikaga T: Transcutaneous muscle stimulation as a method to retard disuse atrophy. Gin Orthop Relat Res 1982; 164: 215-20.