Objective To investigate the correlation between subacromial space and acromial shoulder impingement syndrome (SIS).Methods The clinical and imaging data of 40 patients with SIS were collected and retrospectively reviewed.The shape of acromion and tears of rotator cuff of all patients were classified.A cromion-Humerus (A-H) distance was measured.Results Among 40 patients,there were 9 cases of type Ⅰ,12 cases of type Ⅱ,19 cases of type Ⅲ.32 patients had subacromial space narrowing.7 cases had calcification in the supraspinatus tendon and 10 patients had acromioclavicular joint ostcoarthritis.There were 17 cases of type Ⅰ,15 cases of type Ⅱ,18 cases of type Ⅲ of tears of rotator cuff.6 patients had subacromial bursa thickening,5 patients had subacromial-deltoid sac fluid and 10 patients had the joint capsule fluid.2 patients had jointlabrum avulsion,3 patients had the supraspinatus muscle atrophy and 4 patients had Bankart Lesion.There was no significant difference was found in A-H distance measured with X-ray and MRI(P =0.137 0).There was positive correlation between the A-H distance and class of rotator cuff(r =0.545,P =0.000 1).Conclusion There exists some correlation between subacromial space and SIS.The diagnosis and class of SIS can be assessed according to narrowing range of subacromial space.

Aim: To treat patients with periarthritis of shoulder by using acupuncture at myofascial trigger points around shoulder, and observe the clinical effects. Methods: Thirty cases suffering from shoulder periathritis with the motion restriction of abduction and anterior flexion of shoulder were selected from the Department of Orthopedics, Yuxi People's Hospital between April 2002 and October 2004. They were treated with acupuncture of lidocaine injection (10 g/L) at trigger points of the deltoid muscle and biceps brachii muscle around shoulder, once every 7-12 days for two or three times. They also participated in the stretch exercise of deltoid muscle and biceps brachii muscle and deltoid muscle for three times a day. The ache and motion range of shoulder joints in all the patients were evaluated with the self-made scoring system at 3 months after operation (the total score was 8, 1 as painless, 8 as severe, the motion of should joint was restricted and nyctalgia). Results: According to intention-to-treat analysis, all the 30 cases were involved in the analysis of results. 1 Aching score: The aching score at 3 months after treatment was obviously lower than that before treatment [(1.40±0.67), (5.90±0.99) points, t=48.7, P < 0.01]. 2 Motion range of shoulder joints: The average abduction and anterior flexion after treatment were obviously larger than those before treatment (113.4° vs 46.3°, 98.4° vs 33.5°). Conclusion: Acupuncture treatment in periarthritis of shoulder can obviously relieve ache, and improve the motion disorder of shoulder joints caused by it.

Aim: To observe the effect of the principle of myofacial trigger points pain in diagnosing lateral epicondylitis and ameliorating pain of the patients. Methods: Thirty-five patients (24 males and 11 females) with lateral epicondylitis aged 23-65 years were selected from the Department of Orthopedics, Yuxi People's Hospital from January 2001 to December 2004. The painful sites of myofacial trigger point in the patients were treated with acupuncture repeatedly, once every 7-12 days for two or three times. A stretch therapy of elbow lateral and medial muscles and some medications, such as multi-vitamin and drug for the amelioration of peripheral circulation were also given for 3-6 months. After treatment, the patients were assessed with the self-designed pain scale, the total score was 6 points, 1 as painless, and 6 as severe pain. Results: All the 35 patients were involved in the analysis of results. The average score after treatment was obviously lower than that before treatment [(1.20±0.40), (4.40±1.03) points, t=16.8, P < 0.001]. Conclusion: The myofascial trigger points of lateral muscle groups of elbow are the main causes of the lateral epicondylitis. The treatment above to myofacial trigger points pain is an easy and effective method.

Aim: To observe the effect of combined therapy with stretch and drugs in relieving quadratus lumborum myofascial trigger point pain of patients. Methods: Sixty-eight patients with quadratus lumborum myofascial trigger point pain were selected form inpatients in the Department for Nationalities, Yuxi Hospital of Traditional Chinese Medicine, Yunnan Province. The selected patients were divided into treatment group(n = 35) and control group (n = 33) randomly. In the treatment group, patients undertook manipulation of squeeze and stretch on involved muscles; Before stretch, trigger point was injected Chinese angelica parenteral solution, and meanwhile Chinese drugs that can improve peripheral circulation, such as radix notoginseng, compound radix salviae miltiorrhizae and shaofu zhuyu tang were taken orally. In the control group, the trigger points of the patients were injected 10 g/L anestacon before stretch. After treatment, the patients were taught to self-stretch at home, and then followed up. Pain scale was self-drafted before and after treatment. Results: The drafted pain scale of patients in the treatment group was (3.54 ± 1.19) points before treatment. After treatment, 25 cases had 0 point, 5 had 1 point and 5 had 2 points; 25 cases were cured, 5 were effectively improved and 5 were improved. The drafted pain scale of patients in the control group was (3.55 ± 1.08) points before treatment. After treatment, 20 cases had 0 point, 3 had 1 point, 2 had 2 points and 8 had 3 points; 20 cases were cured, 3 were effectively improved, 5 were improved and 8 were ineffectively treated. There was significant difference in the curative effect between the two groups. Conclusion: The combined therapy for quadratus lumborum myofascial trigger point pains is effective in improving pain, strengthening muscle and promoting inflammatory absorption.