Background Shoulder impingement syndrome (SIS) is a common causes of shoulder pain and the night pain is a frequent symptom of this condition (1,2). Short wave diathermy (SWD) is a deep diathermic agents used in the treatment of musculoskeletal system disorders. Local inflammation could be the major cause of night pain, and using a deep diathermic modality might be contradictory.
Objectives Investigation of the effectiveness of short wave diathermy SWD treatment in patient with SIS and to emphasize the significance of night pain (NP) status on treatment response.
Methods In this double-blind, randomized placebo controlled trial, 57 patients aged between 35 to 65 years, diagnosed as SIS were classified into two groups as night pain positive NP(+) (n=28) and night pain negative NP(-) (n=29). Both groups were randomly assigned to SWD treatment NP(+) n=14, NP(-) n=14 and sham NP(+) n=15, NP (-) n=14 subgroups. Exercise, cold pack application and a non-steroidal anti-inflammatory drug treatment were applied to all groups. 27.12 MHz continuous SWD (daily 20 min per session, 5 days per week, for 2 weeks, 10 sessions) was applied to the treatment groups while sham SWD was applied to the sham groups with the same protocol. Rest, activity and night visual analog scale (VAS), Constant (Murley) Score (CS) and Shoulder Disability Questionnaire (SDQ) were used for evaluation of patients at 2 weeks before the treatment, 1 month and 2 months after the treatment.
Results There were no statistical differences between the SWD treatment and sham groups in all outcome parameters except for the Constant pain scores in NP (+) group. In NP(-) group, SWD treatment improved the parameters of pain, strength, total scores of CS, and SDQ compared to sham group at 1 month. SWD treatment was superior to sham for all parameters except for the Constant daily living activity scores at 2 months.
Conclusions In conclusion, addition of 27.12 MHz continuous SWD treatment to conventional therapies provides long term benefits when compared to sham SWD in terms of rest and activity VAS scores, Constant-Murley scores, and SDQ scores in SIS patients without night pain. However, there was no convincing evidence that SWD treatment is of additional benefit in SIS patients with NP. Therefore; night pain as a symptom should be regarded in the selection of treatment modalities in order to use the deep heaters effectively in the management of SIS.
Van der Windt DA, Koes BW, de Jong BA, Bouter LM (1995) Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis 54(12), 959–964.
Minns Lowe CJ, Moser J, Barker K (2014) Living with a symptomatic rotator cuff tear “bad days, bad nights”: a qualitative study. BMC Musculoskelet Disord 15:228.
Disclosure of Interest None declared