OBJECTIVE: To reveal the gap between the evidence of systematic reviews (SRs) and clinical concerns by systematically summarizing the evidence on acupuncture and moxibustion for frozen shoulder and investigating the concerns and needs of clinicians in treatment with acupuncture and moxibustion for this disease. METHODS: The articles of SR and Meta-analysis on acupuncture and moxibustion for frozen shoulder were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library, starting from the inception of each database up to December 31st, 2022. Two researchers screened the articles and extracted data independently. Using AMSTAR-2, the methodological quality of the included studies was evaluated. Based on systematic reviews and expert discussion, a questionnaire on clinical concerns of acupuncture and moxibustion for frozen shoulder was developed and distributed to clinicians. The discrepancies between the evidence and clinical concerns were compared from 5 dimensions, including population, interventions, control measures, outcome indicators and review time points. RESULTS: The evidence gaps existed between SRs and clinical concerns. In the existing studies, the needs of personalized treatment were not fully considered in terms of different syndromes/patterns of frozen shoulder and stages of illness, the outcome indicators were not employed properly, the time for outcome measurement was vague, the control groups were set up outside of standardization, and the methodological quality was lower. CONCLUSION It is suggested that future studies should improve the quality of methodology, lay more consideration to different patient groups, optimize outcome indicators and standardize the setting of control groups, so as to better meet the needs of patients and achieve the best match between evidence and clinicians' needs.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Evidence Gaps ; Moxibustion ; Systematic Reviews as Topic ; Meta-Analysis as Topic

This study aims to construct the core outcome set for the clinical trials of adhesive capsulitis treated with acupuncture and moxibustion. Using systematic review, semi-structured interview, Delphi questionnaire survey, analytic hierarchy process and expert consensus meeting, the primary outcomes are obtained, i.e. local tenderness, pain degree during movement, range of motion, changes in range of motion, function score, and score of local symptoms of shoulder joint. The secondary outcomes are myofascial thickness, thickness of the inferior wall of the joint capsule, health status, activity of daily living, incidence of adverse events, laboratory indexes, vital signs, cost-effectiveness, total effective rate, and patient satisfaction. It is expected to provide a reference for the outcome selection in clinical trials and the generation of medical evidences in the treatment of adhesive capsulitis with acupuncture and moxibustion.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Consensus ; Moxibustion ; Outcome Assessment, Health Care

The clinical evidences on acupuncture and moxibustion for the treatment of frozen shoulder were sorted and summarized systematically. The relevant articles of frozen shoulder treated with acupuncture and moxibustion were searched from PubMed, EMbase, Cochrane database of systematic review (CDSR), Cochrane database of controlled trials register (CENTRAL), China national knowledge infrastructure (CNKI), Wanfang, VIP, and Chinese biomedical literature databases (SinoMed), from database inception to May 31, 2021. Using AMSTAR-2, the methodological quality of the included systematic reviews was evaluated. With evidence map, the current status of clinical evidence was summarized on acupuncture and moxibustion in treatment of frozen shoulder. A total of 266 original studies and 6 systematic reviews were included finally. At present, many randomized controlled trials are designed with small sample size and the simple acupuncture and moxibustion therapy is dominant as the intervention, e.g. warm acupuncture, acupuncture with filiform needle, acupotomy and electroacupuncture. The outcomes considered in the current trials focus on clinical effective rate, the score of shoulder pain, the score of shoulder function and the score of quality of life. Most of the studies have shown that acupuncture and moxibustion is advantageous as an adjunctive therapy for frozen shoulder, but its clinical evidence is few in terms of the recurrence rate and safety. Moreover, it needs to improve the evidence quality of the relevant studies on acupuncture and moxibustion for frozen shoulder.
Acupuncture Therapy ; Bursitis/therapy* ; Electroacupuncture ; Humans ; Moxibustion ; Quality of Life

OBJECTIVE: To explore the clinical efficacy of focused extracorporeal shock wave therapy with centrifugal exercise in the treatment of greater trochanteric pain syndrome. METHODS: From September 2017 to June 2019, 53 eligible cases of greater trochanteric pain syndrome were randomly divided into observation group (29 cases) and control group (24 cases). In observation group, there were 8 males and 21 females, aged from 38 to 62 years old with an average of (49.96±6.39) years old; the course of disease ranged from 6 to 13 months with an average of (8.58±1.99) months;treated with focused extracorporeal shock wave therapy with centrifugal exercise. In control group, there were 5 males and 19 females, aged from 39 to 62 years old with an average of (52.79±5.86) years old;the course of disease ranged from 6 to 14 months with an average of (9.04±2.51) months;treated with centrifugal exercise alone. Visual analogue scale (VAS) and hip Harris score were measured before ESWT treatment and at 1, 2, and 6 months to evaluate relieve degree of pain and functional recovery of hip joint, respectively. RESULTS: At 1 month after treatment, there were no significant differences in VAS, hip Harris score and treatment success rate (all CONCLUSION In treatment of greater trochanteric pain syndrome, focused extracorporeal shock wave therapy with centrifugal exercise could significantly relieve symptoms of lateral hip pain, improve functional recovery of hip joint with good safety. This treatment strategy is worthy of application and promotion in clinical practice.
Adult ; Arthralgia ; Bursitis ; Extracorporeal Shockwave Therapy ; Female ; Hip ; Hip Joint ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVE: To compare clinical effects of inside-out technique and outside-in technique for the treatment of idiopathic frozen shoulder under arthroscopy. METHODS: From April 2015 to July 2019, 65 patients with primary frozen shoulder were divided into observation group and control group according to different treatment methods. In observation group, there were 32 cases, including 14 males and 18 females, aged 48 to 64 (54.82±5.35) years old, 18 cases on the right side and 14 cases on the left side. The course of disease was 4 to 10 (7.76±1.19) months. The patients were treated with outside in technique. In control group, there were 33 cases, 16 males and 17 females, aged 45 to 62 (54.64±4.16) years old, 18 cases on the right side and 15 cases on the left side. The course of disease was 5 to 9 (7.65±1.24) months. The patients were treated with inside out technique. The operation time, hospitalization days and treatment cost were compared between the two groups. Constant-Murley function score before and after the operation andthe shoulder joint range of motion one month after operation were compared to evaluate the clinical efficacy. RESULTS: All 65 patients were followed up for 9 to 17 months with an average follow up time of (11.34±2.24) months. Compared with control group, operation time in observation group was shorter[(55.53± 10.23) min vs (85.58±13.39) min], and functional scores of Constant-Murley after surgery were significantly changed in both groups compared with that before surgery( CONCLUSION The two arthroscopic release schemes have achieved satisfactory results for thetreatment of primary frozen shoulder, and the shoulder joint function and pain degree have been effectively improved. Compared with the inside-out technique, the outside in release technique is more direct, the operation is simpler and the operation time is shorter. It has certain advantages in releasing operation for primary frozen shoulder.
Arthroscopy ; Bursitis/surgery* ; Female ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Shoulder Joint/surgery* ; Treatment Outcome

OBJECTIVE: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder.METHOD: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks.RESULTS: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI.CONCLUSION: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.
Adrenal Cortex Hormones ; Bursitis ; Diagnosis ; Follow-Up Studies ; Humans ; Injections, Intra-Articular ; Medical Records ; Methods ; Range of Motion, Articular ; Retrospective Studies ; Shoulder

OBJECTIVE: To observe the clinical efficacy of minimally invasive acupotomy-injection technique with targeted three-point in the treatment of frozen shoulder. METHODS: From March 2017 to November 2018, a total of 140 patients with frozen shoulder were randomly divided into observation group and control group. The observation group was made up of 70 patients, including 30 males and 40 females; the mean age was (59.2±11.5) years old; the mean duration of disease was (6.76±4.14) months; the observed patients were treated with acupotomy-injection technique with targeted three-point. There were also 70 patients in the control group, made up of 29 males and 41 females; the mean age was (58.9±11.8) years old; the mean duration of disease was (6.65±3.98) months; the control group was treated with the small needle knife therapy. Before treatment and one month after the treatment, the pain levels of both groups were assessed using the short-form McGill pain questionnaire, and the shoulder function was evaluated using the Constant-Murley Shoulder Outcome Scoring. The clinical efficacy of between groups was compared after treatment, and finally, the improvement rate of pain degree was used to evaluate the therapeutic effect of the patients. RESULTS: The PRI, VAS, PPI and total pain scores of frozen shoulder patients in both groups decreased significantly one month after the treatment compared with those before treatment (<0.01). Compared with the control group, the observation group exhibited a more significant decrease in pain scores (<0.01). Furthermore, the shoulder pain, muscle strength, ADL, ROM and total function scores of frozen shoulder patients in the two groups were significantly improved one month after the treatment compared with those before treatment(<0.01). The inter-group comparison indicated that the pain, ADL, ROM and total function scores were improved obviously in the observation group when compared to those in the control group(<0.01), but no remarkable difference was found between muscle strength score and the control group(>0.05). In addition, the markedly effective rate of pain improvement was 70.0% and 45.7% in the observation group and the control group, respectively, meanwhile, the corresponding total effective rate was 97.1% and 84.3%, respectively. CONCLUSIONS The application of acupotomy-injection technique with targeted three-point in the treatment of frozen shoulder shows definite efficacy, easy operation, little pain and high safety. Therefore, it is an ideal method for minimally invasive treatment.
Acupuncture Therapy ; Aged ; Bursitis ; Female ; Humans ; Male ; Middle Aged ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Treatment Outcome

Plantar heel pain is a common clinical problem in foot and ankle clinics. Typically, several conditions such as plantar fasciitis, fat pad atrophy, and calcaneal fracture may lead to plantar heel pain. However, subcalcaneal bursitis occurred between plantar fascia and plantar fat pad has rarely been described as a cause of plantar heel pain. To our knowledge, subcalcaneal bursitis has been reported only once, but there was no mention of preceding factors. We firstly present a case of subcalcaneal bursitis occurred after excessive walking exercise known as “Nordic walking” and successfully managed with conservative treatments that relieve impact on plantar heel.
Adipose Tissue ; Ankle ; Atrophy ; Bursitis ; Fascia ; Fasciitis, Plantar ; Foot ; Heel ; Walking

The shoulder is the third most common region in which musculoskeletal pain occurs, involving symptoms that cause a decrease in quality of life and a reduced ability to perform activities of daily life if untreated. Many lesions cause shoulder pain; therefore, we included those commonly encountered in primary care clinics. We aimed to describe the diagnosis and non-operative or conservative treatment modalities of rotator cuff tendinopathy, impingement syndrome, rotator cuff tear, adhesive capsulitis, biceps tendonitis, and acromioclavicular arthritis. Exercise has been reported to be effective for the treatment of impingement syndrome, and the effect of exercise has been shown to reduce pain. Both home-based self-exercise and exercise supervised by professionals are equally effective. Types of exercise should include stretching, active, active-assistive, and resistive exercise. Ten repetitions per set for 3 sets of each exercise should be prescribed initially post-injury. Repetition and resistance should be increased as strength grows. The use of ultrasonography for the diagnosis of shoulder pain has increased recently. Corticosteroid injection under ultrasonographic guidance is effective in reducing pain.
Arthritis ; Bursitis ; Diagnosis ; Muscle Stretching Exercises ; Musculoskeletal Pain ; Primary Health Care ; Quality of Life ; Rotator Cuff ; Shoulder Pain ; Shoulder ; Tears ; Tendinopathy ; Tendons ; Ultrasonography

OBJECTIVE: To identify useful imaging findings for the diagnosis of idiopathic adhesive capsulitis of the hip (ACH) on computed tomography arthrography (CTA). MATERIALS AND METHODS: Twenty-eight consecutive patients (29 hips; 7 males; mean age, 45.7 years; age range, 17–67 years) with ACH from October 2009 to March 2017 and 29 age- and sex-matched control patients from 2014 to 2016 were enrolled. All CTA images were evaluated by 2 radiologists independently for joint distensibility (anterior-posterior [AP] and superior-inferior [SI] joint cavity filling ratios), the presence of contrast filling around the ligamentum teres, and extracapsular contrast leakage. Fisher's exact test, Mann-Whitney U test, analysis of variance, and receiver operating characteristic curves were used for statistical analysis. P value less than 0.05 was considered to indicate statistical significance. RESULTS: The anterior joint cavity was significantly more obliterated in the ACH group (mean size, 3.7–4.0 mm) than in the control group (mean size, 4.8–5.0 mm; p < 0.05). The AP filling ratio was also significantly lower in the ACH group (0.6 vs. 1.1; p < 0.05) and decreased more as the ACH stage increased (mean anterior joint cavity size: 1.15 mm in stage 3 vs. 4.68 mm in stage 1; p < 0.05). Extracapsular contrast leakage was more common in the ACH group (27–28 vs. 20–21; p = 0.041 and 0.025, respectively). CONCLUSION: On CTA, the anterior joint cavity may have earlier and more marked obliteration than joint cavities on other sides, and may be accompanied by extracapsular contrast leakage in ACH. These CTA findings may be helpful in the diagnosis of ACH.
Adhesives ; Arthrography ; Bursitis ; Diagnosis ; Hip ; Humans ; Joints ; Male ; ROC Curve ; Round Ligaments ; Shoulder