title: Co-analgesic therapy for arthroscopic supraspinatus tendon repair pain using a dietary supplement containing Boswellia serrata and Curcuma longa: a prospective randomized placebo-controlled study.
abstract: BACKGROUND
  The cuff tendon that is most prone to full-thickness rotator cuff tears is the supraspinatus (SSP). Arthroscopic SSP repair ensures good to satisfactory mid- to long-term clinical outcomes. However, the intense postoperative pain reduces rehabilitation compliance and is cause of patient dissatisfaction. Many natural compounds act by inhibiting inflammatory pathways in a similar way to anti-inflammatory drugs
  
  
  METHODS
  This was a prospective randomized trial designed to assess the analgesic effect of a dietary supplement (DS) containing Boswellia serrata and Curcuma longa in a population of subjects with full-thickness SSP tendon tear treated by arthroscopy. Three weeks before surgery, patients were randomized to receive Tendisulfur(®) (group T) or a placebo (group P) for 2 months. The primary outcome measure was subjective VAS pain. Secondary outcomes measures were Constant-Murley score simple shoulder test, and patient global assessment (PGA) scores. Patients were assessed immediately at baseline and subsequently at 1, 2, 4, 6, 8, 12, and 24 weeks.
  
  
  RESULTS
  Stratification of pain scores and subscores demonstrated significantly lower overall pain scores in group T versus group P at 1 week (p = 0.0477), and lower but not significantly different scores on week 2 (p = 0.0988); at subsequent time points, differences were not significant (p > 0.05). PGA scores were good in all subjects.
  
  
  CONCLUSIONS
  In conclusion, this study provides objective data on the effect of a DS containing natural substances, added to standard analgesics, on postoperative RC pain. DS alleviated short and partially mid-term pain, while long-term pain was unchanged. This limitation can probably be addressed by a dosage increase over the first 4 weeks and by extending treatment by 1 or 2 months.
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy. giovannimerolla@hotmail.com.|"Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica, Cattolica, Italy. giovannimerolla@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Merolla
authors.affiliation: "Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica, Cattolica, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Dellabiancia
authors.affiliation: Unit of Anesthesiology and Intensive Care, Riccione and Cattolica Hospitals - AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ingardia
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Paladini
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Porcellini
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001120:Arginine / Q000008:administration & dosage / Q000627:therapeutic use; D001182:Arthroscopy; D029743:Boswellia / Q000737:chemistry*; D024042:Collagen Type I / Q000008:administration & dosage / Q000627:therapeutic use; D024043:Collagen Type II / Q000008:administration & dosage / Q000627:therapeutic use; D030024:Curcuma / Q000737:chemistry*; D019587:Dietary Supplements; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006025:Glycosaminoglycans / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008239:Lysine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D012421:Rupture / Q000601:surgery; D013450:Sulfones / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D024042:Collagen Type I; D024043:Collagen Type II; D004338:Drug Combinations; D006025:Glycosaminoglycans; D010936:Plant Extracts; D013450:Sulfones; D001120:Arginine; C025910:dimethyl sulfone; D008239:Lysine; D004121:Dimethyl Sulfoxide
keywords: Arthroscopy; Co-analgesia; Dietary supplements; Supraspinatus pain