Efficacy and safety of Tuina and intermediate frequency electrotherapy for frozen shoulder: MRI-based observation evidence

Jian-Min Wang; Shuai-Shuai Mi; Li-Jun Zheng; Ying-Jie Qiao; Wan-Li Zhang; Kun Xue; Hua-Dong Li

Efficacy and safety of Tuina and intermediate frequency electrotherapy for frozen shoulder: MRI-based observation evidence

Am J Transl Res. 2023 Mar 15;15(3):1766-1778. eCollection 2023.

Authors

Jian-Min Wang¹, Shuai-Shuai Mi², Li-Jun Zheng¹, Ying-Jie Qiao¹, Wan-Li Zhang¹, Kun Xue¹, Hua-Dong Li¹

Affiliations

¹ Department of Tuina, Shandong University of Traditional Chinese Medicine Affiliated Hospital Jinan, Shandong, China.
² School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine Jinan, Shandong, China.

PMID: 37056812
PMCID: PMC10086926

Abstract

Background: Tuina and Intermediate Frequency (IF) electrotherapy are commonly used treatments for frozen shoulder (FS). This study aimed to compare the clinical efficacy of Tuina and IF electrotherapy in the treatment of stage II frozen shoulder and to provide evidence-based treatment for FS.

Methods: The FS patients were randomized into two groups, the observation group, which received Tuina, and the control group, which received IF electrotherapy. The total treatment duration was 20 minutes per treatment, 3 times per week; the treatment period was 6 weeks. Assessments were performed at baseline, 3 weeks, 6 weeks, and 16 weeks after follow-up. Primary assessments included visual analog scale (VAS), Constant-Murley scale (CMS), and secondary assessments included shoulder MRI, rotator cuff muscle diffusion tensor imaging (DTI).

Results: A total of 57 patients participated in this study, in the observation group (n = 29) and the control group (n = 28). At the end of the 3rd and 6th weeks of treatment, Tuina was significantly more effective than IF electrotherapy in reducing the VAS score and improving the Constant-Murley total score (P<0.05), but there was no significant difference in scores between the two groups at the 16-week follow-up (P>0.05). MRI results in both groups: compared to the control group, the observation group had better results in reducing the degree of periapical edema and reducing the thickness of the axillary humeral capsule (P<0.05); and the observation group had significantly more efficacy than the control group in improving the diffusion state of water molecules in the rotator cuff muscles (P<0.05).

Conclusion: Tuina is more effective than IF electrotherapy in improving the symptoms of FS patients as it can rapidly relieve the pain and restore the function of the affected shoulder, reduce the edema of the shoulder capsule, restore the function of the rotator cuff muscles, and shorten the natural course of FS. Name of the registry: This study was registered in the Shandong University of Traditional Chinese Medicine Affiliated Hospital; Grant No. (2021) Lun Audit No. (033) - KY; Date of registration: 2021.4.27.

Keywords: Frozen shoulder; IF electrotherapy; MRI; RCT; Tuina.