Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: A randomized controlled trial

Abstract

Objective. To explore the effectiveness of naturopathic care (NC) on rotator cuff tendinitis using a prospective randomized clinical trial design. Methods. Canadian postal workers with rotator cuff tendinitis for a duration of >6 weeks were randomized to receive NC (n ‫؍‬ 43) or standardized physical exercises (PEs; n ‫؍‬ 42) over 12 weeks. Participants in the NC group received dietary counseling, acupuncture, and Phlogenzym (2 tablets 3 times/day). The PE intervention group received passive, activeassisted, and active range of motion exercises and matched placebo. The primary outcome measure was the Shoulder Pain and Disability Index (SPADI), and secondary outcomes were the pain visual analog scale (VAS), Short Form 36 (SF-36), Measure Yourself Medical Outcomes Profile (MYMOP), and shoulder maximal range of motion. Participants and assessors were blinded to group and placebo allocation. Results. Seventy-seven participants (87%) completed >8 weeks of the trial. Final total SPADI scores decreased by 54.5% (P < 0.0001) in the NC group and by 18% (P ‫؍‬ 0.0241) in the PE group. Between-group differences in changes to SPADI scores showed statistically significant decreases in shoulder pain and disability in the NC group compared with the PE group (P < 0.0001). Significant differences between groups were also observed in the pain VAS, MYMOP, SF-36, and shoulder extension, flexion, and abduction, with the NC group showing superiority in each outcome. No serious adverse reactions were observed. Conclusion. NC and PE provided significant improvements, with greater improvement in shoulder function in the NC group compared with the PE group. Statistically significant improvements in quality of life measures were observed in the NC group as compared with the PE group.

Estimated Effects of Whole-system Naturopathic Medicine in Select Chronic Disease Conditions: A Systematic Review

“…Results from hand searching added two additional studies: a more recently published randomized controlled trial (RCT) & companion cost-effectiveness analysis (CEA). In total, 15 studies of whole practice naturopathic medicine were included [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Figure 1 shows the literature flowchart.…”

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

“…A detailed description of the soft tissue and MT was not provided by the single study. 49 For ESWT, 2 acceptable-quality reviews both found that ESWT was not effective for noncalcific rotator cuff tendinitis. 37,49 For TENS, a high-quality review found that because of the scarcity of evidence and high risk of bias of existing studies, no conclusions could be made about its effectiveness.…”

“…49 For ESWT, 2 acceptable-quality reviews both found that ESWT was not effective for noncalcific rotator cuff tendinitis. 37,49 For TENS, a high-quality review found that because of the scarcity of evidence and high risk of bias of existing studies, no conclusions could be made about its effectiveness. 31 For taping, an acceptable-quality review found that the evidence for taping alone or with other therapies was insufficient to make a conclusion.…”

“…Five acceptable-quality reviews 36,38,47,49,50 and 1 high-quality review 35 addressed rotator cuff calcific tendinitis (RC-CT). The first SR included 20 individual studies (1544 participants).…”

“…35 The second review 36 by the same team found that with the 22 studies that were included (1258 shoulders), many patients can achieve good to excellent clinical outcomes after high-energy ESWT, US-guided needling, and arthroscopy for calcific tendinopathy of the shoulder. Two additional acceptable-quality reviews both found that ESWT was effective for RC-CT. 37,49 The other reviews in this category analyzed similar treatments and outcomes. One review (6 studies included, 460 patients) evaluated the effectiveness of ESWT for functional improvement and reduction of pain in patients with calcific tendinitis of the shoulder.…”