Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial.
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, active-assisted, 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 >or=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.


CONCLUSIONS
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.
Szczurko
Orest
O
Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada.
Cooley
Kieran
K
Mills
Edward J
EJ
Zhou
Qi
Q
Perri
Dan
D
Seely
Dugald
D
D015670:Acupuncture Therapy; D001963:Bromelains / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004032:Diet; D037001:Directive Counseling; D004185:Disability Evaluation; D004338:Drug Combinations; D004651:Employment; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009324:Naturopathy; D009784:Occupational Diseases / Q000503:physiopathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011177:Postal Service; D011446:Prospective Studies; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000503:physiopathology*; D012431:Rutin / Q000031:analogs & derivatives / Q000627:therapeutic use; D020069:Shoulder Pain / Q000503:physiopathology / Q000628:therapy*; D052256:Tendinopathy / Q000503:physiopathology / Q000628:therapy*; D014357:Trypsin / Q000627:therapeutic use
D004338:Drug Combinations; C119937:Phlogenzym; D012431:Rutin; D001963:Bromelains; D014357:Trypsin