Effectiveness of Court-type Thai Traditional Massage Combined with Herbal Compress on Pain Intensity and Shoulder Range of Motion in Patients with Frozen Shoulder
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Abstract
Introduction and Objective: Frozen shoulder (adhesive capsulitis) is caused by chronic inflammation of the synovial membrane and thickening of the joint capsule, which leads to the narrowing of the joint cavity. This results in shoulder stiffness and limited movement. In Thai therapeutic massage (TTM), this disease is known as “Hua Lai Tit” and is divided into two types: acute frozen shoulder and chronic frozen shoulder. Previous studies have reported the effectiveness of court-type Thai traditional massage (CTTM) combined with Thai herbal compresses (THC) in significantly reducing pain levels and improving the range of motion in the neck and knee joints. However, evidence regarding its effectiveness in patients with frozen shoulder remains limited. Therefore, the objective of this study was to investigate the effectiveness of CTTM combined with THC in patients with chronic frozen shoulder. This preliminary quasi-experimental study employed a single-group design with pre- and post-intervention assessments. The protocol was approved by the Human Research Ethics Committee of Mahasarakham University (Ref. no. 319-317/2566).
Methods: This study aims to evaluate the effectiveness of CTTM combined with THC on pain scores using visual analog scale (VAS) and shoulder range of motion (SROM) in all directions: flexion, extension, abduction, adduction, internal rotation, and external rotation. Thirty participants with frozen shoulder were recruited. Participants were given 8 sessions of CTTM+THC treatment (2 sessions per week) during a four-week period. The assessments of pain scores and SROM were performed prior to the treatment (baseline), at the end of treatment period (4th week), and two weeks after the treatment ended (6th week). Data were statistically analyzed using paired samples t-test.
Results: Most of research participants were female, aged 50–69, and had right-sided frozen shoulder. The study found a statistically significant decrease (p < 0.05) in the average shoulder pain score. The mean VAS scores before treatment, after 4 weeks, and after 6 weeks were 4.47 ± 0.33, 2.61 ± 0.45, and 2.40 ± 0.44, respectively. In addition, the average shoulder range of motion also increased in all directions, with a statistically significant improvement (p < 0.05). The average SROM values before treatment, after 4 weeks, and after 6 weeks for each movement were as follows: Flexion (raising the arm forward): 105.8 3 ± 6.24, 119.50 ± 5.55, 121.2 ± 6.88 degrees; Extension (raising the arm backward): 29.30 ± 5.56, 39.70 ± 5.01, 41.20 ± 3.66 degrees; Abduction (raising the arm out to the side): 80.06 ± 5.49, 93.63 ± 5.36, 92.90 ± 6.09 degrees; Adduction (lowering the arm to the side): 15.64 ± 4.12, 24.11 ± 5.26, 23.77 ± 4.96 degrees; Internal rotation (rotating the shoulder inward): 29.30 ± 4.92, 37.73 ± 4.78, 37.10 ± 4.42 degrees; and External rotation (rotating the shoulder outward): 27.36 ± 5.05, 37.16 ± 5.68, 36.20 ± 5.55 degrees.
Discussion: CTTM combined with THC is a recognized and effective treatment option within Thailand's healthcare system for musculoskeletal disorders. This therapy is known to improve blood and lymphatic circulation, enhance relaxation, reduce tissue tension, and decrease pain levels. As demonstrated in this study, the integrated therapy of CTTM and THC effectively reduced pain, alleviated chronic shoulder inflammation, and improved the shoulder's range of motion in all directions. These positive outcomes were observed after a course of eight treatments, administered twice per week over a period of four weeks.
Conclusion and recommendation: The combination of court-type Thai traditional massage and Thai herbal compresses is shown to be effective in reducing pain intensity and enhancing SROM in all directions. Future research should compare the combined therapy of massage and herbal compresses with a standard conventional medical treatment, while also increasing the number of research participants.
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