DOI QR코드

DOI QR Code

A Randomized Controlled Clinical Trial of Topical Herbal Gel Treatment for Chronic Shoulder Pain

만성 어깨 통증의 한약 추출 외용 젤 치료에 대한 임상연구

  • Jo, Su Jeong (Department of Acupuncture & Moxibustion Medicine, Dongguk University Ilsan Oriental Hospital) ;
  • Choi, Young Doo (Department of Acupuncture & Moxibustion Medicine, Dongguk University Ilsan Oriental Hospital) ;
  • Jang, Jin Taek (Samdae Korean Medicine Clinic) ;
  • Kim, Kap Sung (Department of Acupuncture & Moxibustion Medicine, Dongguk University Ilsan Oriental Hospital) ;
  • Lee, Seung Deok (Department of Acupuncture & Moxibustion Medicine, Dongguk University Ilsan Oriental Hospital)
  • 조수정 (동국대학교 일산한방병원 침구의학과) ;
  • 최영두 (동국대학교 일산한방병원 침구의학과) ;
  • 장진택 (삼대한의원) ;
  • 김갑성 (동국대학교 일산한방병원 침구의학과) ;
  • 이승덕 (동국대학교 일산한방병원 침구의학과)
  • Received : 2014.09.02
  • Accepted : 2014.10.27
  • Published : 2014.12.20

Abstract

Objectives : The aim of this study is to evaluate the efficacy of a topical herbal gel application for the treatment of chronic shoulder pain. Methods : We compared the effects of Dapureo gel, which contains several herbal medicines known to improve shoulder pain, with those of placebo gel by double-blind method. 30 participants were randomized - 15 were assigned to treatment group and the other 15 were assigned to control group. Either Dapureo gel(treatment group) or placebo gel(control group) was applied topically by themselves, once a day for 2 weeks. Primary outcome was daily visual analogue scale(VAS) changes for shoulder pain which was self-reported for 2 weeks. Secondary outcome was the difference in the total shoulder pain and disability index(SPADI) which was measured at a baseline and 2 weeks after the treatment. Results : Primary outcome: Subjects of treatment group showed statistically significant improvement in VAS compared to control subjects continuously from the second day(p <0.05) to the fifteenth day(p <0.001). The treatment group showed 31% of pain reduction on the fifteenth day, while the control group showed only 7%. Secondary outcome: In terms of SPADI changes, the treatment group showed improvement compared to the control group(p <0.01). Conclusions : These results suggest that the topical herbal gel treatment used in this study is effective in improving chronic shoulder pain.

Keywords

References

  1. Van der Heijden GJ. Shoulder disorders: a state-of-the-art review. Best Pract Res Clin Rheumatol. 1999 ; 13(2) : 287-309. https://doi.org/10.1053/berh.1999.0021
  2. Marinko LN, Chacko JM, Dalton D, Chacko CC. The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis. J Shoulder Elbow Surg. 2011 ; 20(8) : 1351-9. https://doi.org/10.1016/j.jse.2011.05.013
  3. Stevenson K. Evidence-based review of shoulder pain. Musculoskeletal Care. 2006 ; 4(4) : 233-9. https://doi.org/10.1002/msc.96
  4. Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev. 2003 ; 1(1) : 1-54
  5. Ginn KA, Herbert RD, Khouw W, Lee R. A randomized, controlled clinical trial of a treatment for shoulder pain. Phys Ther. 1997 ; 77(8) : 802-9.
  6. Macfarlane G, Hunt I, Silman A. Predictors of chronic shoulder pain: a population based prospective study. J Rheumatol. 1998 ; 25(8) : 1612-5.
  7. Falla D, Hess S, Richardson C. Evaluation of shoulder internal rotator muscle strength in baseball players with physical signs of glenohumeral joint instability. Br J Sports Med. 2003 ; 37(5) : 430-2. https://doi.org/10.1136/bjsm.37.5.430
  8. Data for the top 100 outpatient disease in Korea 2011-2013. Statistical informations of Disease and treatment. Health Insurance Review & Assessment Service [online] 2013[cited 2014 Aug 28]. Available from : http://www.hira.or.kr/
  9. Green S, Buchbinder R, Glazier R, Forbes A. Interventions for shoulder pain. Cochrane Database Syst Rev. 2002 ;(3) : CD001156
  10. Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev. 2003; (2) : CD004258
  11. Nabeta T, Kawakita K. Relief of chronic neck and shoulder pain by manual acupuncture to tender points - a sham-controlled randomized trial. Complementary Ther Med. 2002 ; 10(4) : 217-22. https://doi.org/10.1016/S0965-2299(02)00082-1
  12. Guerra de Hoyos JA, Martín MdCA, Baena de Leon EB et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. 2004 ; 112(3) : 289-98. https://doi.org/10.1016/j.pain.2004.08.030
  13. Molsberger AF, Schneider T, Gotthardt H, Drabik A. German randomized acupuncture trial for chronic shoulder pain(GRASP)-a pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Pain. 2010 ; 151(1) : 146-54. https://doi.org/10.1016/j.pain.2010.06.036
  14. Koh PS, Seo BK, Cho NS, Park HS, Park DS, Baek YH. Clinical effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a randomized controlled trial. J Shoulder Elbow Surg. 2013 ; 22(8) : 1053-62. https://doi.org/10.1016/j.jse.2012.10.045
  15. Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther. 2008 ; 38(7) : 389-95. https://doi.org/10.2519/jospt.2008.2791
  16. Stanos SP. Topical agents for the management of musculoskeletal pain. J Pain Symptom Manage. 2007 ; 33(3) : 342-55. https://doi.org/10.1016/j.jpainsymman.2006.11.005
  17. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical glyceryl trinitrate application in the treatment of chronic supraspinatus tendinopathy a randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med. 2005 ; 33(6) : 806-13. https://doi.org/10.1177/0363546504270998
  18. Spacca G, Cacchio A, Forgacs A, Monteforte P, Rovetta G. Analgesic efficacy of a lecithin-vehiculated diclofenac epolamine gel in shoulder periarthritis and lateral epicondylitis: a placebo-controlled, multicenter, randomized, double-blind clinical trial. Drugs Exp Clin Res. 2005 ; 31(4) : 147-54.
  19. Min DL, Park EJ, Kang KH. Review of clinical and experimental studies on external application treatment for atopic dermatitis in the Korean literature. J Pediatr of Korean Med. 2013 ; 27(1) : 36-49.
  20. Kim KB, Kim TW, Choi SH. Four cases of seborrheic dermatitis treated by fermented Yungyo Keumeunhwa extract external treatment liquid. J Korean Med Ophthalmol Otolaryngol Dermatol. 2013 ; 26(4) : 101-10. https://doi.org/10.6114/jkood.2013.26.4.101
  21. Kim MA, Kim MB, Shin SH et al. The study on external treatment of oriental medical care on acne. J Korean Med Ophthalmol Otolaryngol Dermatol. 2008 ; 21(2) : 102-11.
  22. Heo KJ, Kim EH, Lee BW. A study of external treatment on the obstetric and gynecologic diseases(1) -the part of genital organic diseases. J Oriental Medical Classics. 2007 ; 20(2) : 31-51.
  23. Gemmell HA, Jacobson BH, Hayes BM. Effect of a topical herbal cream on osteoarthritis of the hand and knee: a pilot study. J Manipulative Physiol Ther. 2003 ; 26(5) : 322. https://doi.org/10.1016/S0161-4754(03)00009-5
  24. McKay L, Gemmell H, Jacobson B, Hayes B. Effect of a topical herbal cream on the pain and stiffness of osteoarthritis: a randomized double-blind, placebo-controlled clinical trial. Clin Rheumatol. 2003 ; 9(3) : 164-9. https://doi.org/10.1097/01.RHU.0000073450.85179.55
  25. Li LC, Wong RW, Rabie ABM. Clinical effect of a topical herbal ointment on pain in temporomandibular disorders: a randomized placebo-controlled trial. J Altern Complement Med. 2009 ; 15(12) : 1311-7. https://doi.org/10.1089/acm.2009.0129
  26. Ko GD, Ko GD, Hum A, Traitses G. Do topical herbal agents provide pain relief? Pract Pain Manag. 2006 ; 6(1) : 2-7.
  27. Lee H, Hong KE, Kim YI et al. A acupuncture treatment for frozen shoulder. The Acupuncture. 2006 ; 23(1) : 165-77.
  28. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain(vas pain), numeric rating scale for pain(nrs pain), mcgill pain questionnaire(mpq), short-form mcgill pain questionnaire(sf-mpq), chronic pain grade scale(cpgs), short form-36 bodily pain scale(sf-36 bps), and measure of intermittent and constant osteoarthritis pain(icoap). Arthritis Care Res. 2011 ; 63(S11) : S240-52. https://doi.org/10.1002/acr.20543
  29. Hwang SJ, Mun MH. Relationship of neck disability index, shoulder pain and disability index, and visual analogue scale in individuals with chronic neck pain. Phys Ther Rehabil Sci. 2013 ; 2(2) : 111-4. https://doi.org/10.14474/ptrs.2013.2.2.111
  30. Rainsforda KD, Keanb WF, Ehrlichc GE. Review of the pharmaceutical properties and clinical effects of the topical NSAID formulation, diclofenac epolamine. Curr Med Res Opin. 2008; 24(10) : 2967-92. https://doi.org/10.1185/03007990802381364
  31. Sharma S, Pawar S, Jain UK. Development and evaluation of topical gel of curcumin from different combination of polymers formulation & evaluation of herbal gel. Int J Pharm Pharm Sci. 2012 ; 4(4) : 452-6.
  32. Biradar S, Kangralkar V, Mandavkar Y, Thakur M, Chougule N. Anti-inflammatory, antiarthritic, analgesic and anticonvulsant activity of cyperus essential oils. Int J Pharm Pharm Sci. 2010 ; 2(4) : 123-5.
  33. Galeotti N, Di Cesare Mannelli L, Mazzanti G, Bartolini A, Ghelardini C. Menthol: a natural analgesic compound. Neurosci Lett. 2002 ; 322(3) : 145-8. https://doi.org/10.1016/S0304-3940(01)02527-7
  34. Tjong Y, Ip S, Lao L et al. Analgesic effect of Coptis chinensis rhizomes(Coptidis Rhizoma) extract on rat model of irritable bowel syndrome. J Ethnopharmacol. 2011 ; 135(3) : 754-61. https://doi.org/10.1016/j.jep.2011.04.007
  35. Chen YF, Zhao MH, Yan M et al. Analgesic activity of the aqueous fraction from the ethanolic extract of Chrysanthemum indicum in mice. Pharmazie. 2011 ; 66(7) : 538-42.
  36. Oh JJ, Kim SJ. Inhibitory effect of the root of polygala tenuifolia on bradykinin and COX 2-Mediated pain and inflammatory activity. Trop J Pharm Res. 2013 ; 12(5) : 755-59.
  37. Lee JY, Lee JY, Yun BS, Hwang BK. Antifungal activity of ${\beta}$-asarone from rhizomes of acorus gramineus. J Agric Food Chem. 2004 ; 52(4) : 776-80. https://doi.org/10.1021/jf035204o
  38. Malhotra S, Singh AP. A review of pharmacology of phytochemicals from Indian medicinal plants. IJAM. 2007 ; 5(1) :23-7.

Cited by

  1. 어깨통증의 한의학적 치료에 대한 국내 임상 연구 고찰 vol.41, pp.3, 2020, https://doi.org/10.13048/jkm.20037