Musculoskeletal

Chronic shoulder pain: comparison of acupuncture and conventional treatments

San Jose Care Resource Guide: Chronic shoulder pain can have many causes, the next link  Chronic Shoulder Pain: Part I. Evaluation and Diagnosis   will bring you to an detailed article from Kelton  M. Burnank et. al. on the the diagnosis of the various aspects of it.

•  rotator cuff disorders,
•  adhesive capsulitis,
•  shoulder instability,
•  shoulder arthritis

This article is quite technical: as the it  goes into the details of sub-categories of underlying illness or condition, , the complexities of the diagnosis of the causes of shoulder pain become apparent.

The classical treatments of such causes is described in another article by the same author.  Chronic shoulder pain: part II. Treatment.

Those treatments consist of

• Activity modification and analgesic medications
• physical therapy
•  Combined steroid and local anesthetic injections

Then: “…Symptoms that persist or worsen after six to 12 weeks of directed treatment should be referred to an orthopedic specialist…”

Cure or long term relief does not seem  a given.

Then come a method apparently more benign: accupuncture.  Accupuncture seems to have  some good rate of success according to an article in JAAPA   Chronic Shoulder Pain and Acupuncture Treatment. This article concluded:

“… A treatment series of 15 acupuncture sessions produced signifi­cantly greater pain relief than sham acupuncture or conservative treatment in patients with chronic shoulder pain not due to osteoarthritis or rheuma­toid arthritis…..”

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Comments on “FDA clears Cymbalta to treat chronic musculoskeletal pain”

SJCRG:  Good news, more treatment options for chronic musculoskeletal pain! Here is the link to the FDA press release.   “..Cymbalta was first used to treat major depressive disorder in 2004..” 

SJCRG:  Very interesting is the FDA’s philosophy for drug approval for serious illnesses:

Quoting:  “..While these serious side effects have been associated with the use of Cymbalta, they have occurred in less than 1% of treated patients. There are a finite number of drugs available for the treatment of chronic musculoskeletal pain, all of which are associated with rare, serious side effects. There are patients in whom none of the available treatments are effective. ….

So let us do the math: According to the US Govn’t “..An estimated 1.5 million adults had rheumatoid arthritis in 2007….”
…so 15,000 patients are expected to come down with serious side effects.

 But  “..Since its initial approval, about 30 million patients in the United States have used Cymbalta..[for other conditions]..”  Let us do the math now for that larger population: 1% of 30 million= 300,000 patients with serious side effects!  half of the Multiple sclerosis popultation in the US!

Please do a careful risk/reward analysis with your doctor if you need Cymbalta, or any of these potent drugs….

Cymbalta is no free ride…

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