scholarly journals Physiotherapy or corticosteroid injection for shoulder pain?

2003 ◽  
Vol 62 (5) ◽  
pp. 385-387 ◽  
Author(s):  
D A W M van der Windt
Keyword(s):  
Shoulder Pain ◽  
Corticosteroid Injection

scholarly journals Corticosteroid injection for shoulder pain: single-blind randomized pilot trial in primary care

Trials ◽  
2013 ◽  
Vol 14 (1) ◽  
pp. 425 ◽  
Author(s):  
Tim A Holt ◽  
David Mant ◽  
Andrew Carr ◽  
Stephen Gwilym ◽  
David Beard ◽  
...  
Keyword(s):  
Primary Care ◽  
Shoulder Pain ◽  
Corticosteroid Injection ◽  
Pilot Trial ◽  
Single Blind

scholarly journals Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial

BMJ ◽  
2010 ◽  
Vol 340 (jun28 1) ◽  
pp. c3037-c3037 ◽  
Author(s):  
D. P. Crawshaw ◽  
P. S. Helliwell ◽  
E. M. A. Hensor ◽  
E. M. Hay ◽  
S. J. Aldous ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Exercise Therapy ◽  
Corticosteroid Injection ◽  
Randomised Trial

scholarly journals Acute Symptoms on Rotator Cuff Calcific Tendinitis is Effectively Relieved by Ultrasound Guided Percutaneous Needle Lavage Procedure: a Case Report

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0048
Author(s):  
Tommy Mandagi ◽  
Nyoman Aditya Sindunata ◽  
Prettysia Suvarly ◽  
John Butarbutar
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Acute Pain ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Left Shoulder ◽  
Ultrasound Guided ◽  
Good Outcome ◽  
Limited Range Of Motion ◽  
Infraspinatus Tendon

Introduction: Rotator cuff calcific tendinitis (RCCT) frequently manifests as acute shoulder pain during the acute resorptive phase. Pain typically worse at night and limited range of motion (ROM) with muscle spasm. Several treatment options have been proposed. In this case, a single needle ultrasound-guided percutaneous lavage (UGPL) combined with corticosteroid subdeltoid bursa injection (SDBI) with a good outcome. Case Presentation: A Female, 59 years old, presents with left RCCT acute pain (VAS 7/10) for 2 days and limited painful shoulder ROM. Inflammation and local tenderness found on the left shoulder, ultrasonography shows calcification in the left infraspinatus tendon with sub-deltoid bursa fluid. Patient in sitting position, ultrasound probe placed at long axis of infraspinatus tendon. Using a 23G needle 5 ml syringe, 1% lidocaine infiltrated until the needle penetrates the calcification site. Then a small amount of normal saline (NaCl) with lidocaine injected in a pulsating manner, observed until chalky matter backflows, mixed with NaCl in the syringe. Repeat this procedure until chalky backflow is minimal. Finally, 10 ml of Triamcinolone Acetonide 40 mg mixed with 2 ml lidocaine 2% SDBI using the same needle. Dramatic shoulder pain relieve (VAS 2/10) is immediately achieved after the procedure. One week follow up, the patient is pain-free and regains full ROM of her left shoulder. Discussion: Several methods are proposed for the treatment of acute RCCT, including corticosteroid injection and arthroscopy debridement. UPGL is an attractive option because it is minimally invasive, can be performed in-office setting, and pain relief is obtained immediately by decompressing and removing inflamed calcified sites. Conclusion: The treatment in acute pain RCCT using UGPL combined with corticosteroid SDBI provides a good outcome.

scholarly journals Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of rotator cuff disorders: statistical analysis plan for the Getting it Right: Addressing Shoulder Pain (GRASP) 2 × 2 factorial multicentre randomised controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ioana R. Marian ◽  
Sally Hopewell ◽  
David J. Keene ◽  
Lucy Cureton ◽  
Sarah E. Lamb ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Randomised Controlled Trial ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Best Practice ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Statistical Analysis Plan ◽  
Progressive Exercise ◽  
Randomised Controlled

Abstract Background The Getting it Right: Addressing Shoulder Pain (GRASP) trial assesses the clinical and cost-effectiveness of individually tailored, progressive exercise compared with best practice advice, with or without corticosteroid injection, in adults with a rotator cuff disorder. This article describes the statistical analysis plan for the GRASP randomised controlled trial. Methods/design GRASP is a multicentre randomised controlled trial using a 2 × 2 factorial design. Adults aged ≥ 18 years with a new episode of shoulder pain related to a rotator cuff disorder, not currently receiving physiotherapy or being considered for surgery, are randomised (centralised computer-generated 1:1:1:1 allocation ratio) to one of four interventions: (1) progressive exercise (up to 6 physiotherapy sessions), (2) best practice advice (one physiotherapy session), (3) subacromial corticosteroid injection then progressive exercise and (4) subacromial corticosteroid injection then best practice advice. The primary outcome is the mean difference in Shoulder Pain and Disability Index (SPADI) total score over 12 months. Secondary outcomes are as follows: pain and function SPADI subdomains, health-related quality of life (EuroQol EQ-5D-5L), sleep disturbance, return to activity, global impression of change, health resource use, out-of-pocket expenses and work disability. Here, we describe in detail the following: sample size calculation, descriptive statistics of the primary and secondary outcomes, statistical models used for the analysis of the main outcomes, handling of missing data, planned sensitivity and subgroup analyses. This pre-specified statistical analysis plan was written and submitted without prior knowledge of the trial results. Discussion Publication of the statistical analysis plan for the GRASP trial aims to reduce the risk of outcome reporting bias and increase transparency of the data analysis. Any deviations or changes to the current SAP will be described and justified in the final study report and any results publications. Trial registration International Standard Randomised Controlled Trial Number ISRCTN16539266. Registered on 14 June 2016. EudraCT number 2016-002991-28. Registered on 12 June 2016.

scholarly journals Clinical and cost effectiveness of a corticosteroid injection versus exercise therapy for shoulder pain in general practice: protocol for a randomised controlled trial (SIX Study)

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e050101
Author(s):  
Pieter F van Doorn ◽  
Evelien I T de Schepper ◽  
Dieuwke Schiphof ◽  
Ramon P G Ottenheijm ◽  
Marloes Thoomes-de Graaf ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cost Effectiveness ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Exercise Therapy ◽  
Corticosteroid Injection ◽  
Repeated Measurements ◽  
Life Years

IntroductionShoulder pain is common and the prognosis is often unfavourable. Dutch guidelines on the treatment of shoulder pain in primary care recommend a corticosteroid injection or a referral to exercise therapy, if initial pain management fails and pain persists. However, evidence of the effectiveness of a corticosteroid injection compared with exercise therapy, especially in the long term, is limited. This trial will assess the clinical effectiveness and cost effectiveness of a corticosteroid injection compared with physiotherapist-led exercise therapy over 12 months follow-up in patients with shoulder pain in primary care.Methods and analysisThe SIX Study is a multicentre, pragmatic randomised clinical trial in primary care. A total of 213 patients with shoulder pain, aged ≥18 years presenting in general practice will be included. Patients will be randomised (1:1) into two groups: a corticosteroid injection or 12 sessions of physiotherapist-led exercise therapy. The effect of the allocated treatment will be assessed through questionnaires at 6 weeks and after 3, 6, 9 and 12 months. The primary outcome is patient’s reported shoulder pain-intensity and function, measured with the Shoulder Pain and Disability Index, over 12 months follow-up. Secondary outcomes include cost effectiveness, pain-intensity, function, health-related quality of life, sleep quality, patient’s global perceived effect, work absence, healthcare utilisation and adverse events. Between group differences will be evaluated using a repeated measurements analysis with linear effects models. A cost-utility analysis will be performed to assess the cost effectiveness using quality-adjusted life years from a medical and societal perspective.Ethics and disseminationThis study was approved by the Medical Ethics Committee of Erasmus MC University Medical Center Rotterdam (MEC 2020-0300). All participants will give written informed consent prior to data collection. The results from this study will be disseminated in international journals and implemented in the primary care guidelines on shoulder pain.Trial registration numberDutch Trial Registry (NL8854).

scholarly journals Effectiveness of prolotherapy vs local anesthetic infiltration guided by ultrasound in the treatment of shoulder pain syndrome

2020 ◽  
Author(s):  
Juan A. Lira-Lucio ◽  
Guillermo Ochoa-Gaítan ◽  
Lizeth Hernández-Escobar ◽  
Christian I. Padilla-Rivera ◽  
Berenice C. Hernández Porras ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Local Anesthetic ◽  
Corticosteroid Injection ◽  
Local Treatment ◽  
Pain Syndrome ◽  
Interventional Therapy ◽  
Initial Therapy ◽  
Oncologic Patients ◽  
Local Anesthetic Injection ◽  
Chronic Shoulder Pain

BACKGROUNDChronic Shoulder Pain (CSP) is a health problem that affects almost 67% of the general population. Almost a third of patients with acute shoulder pain syndrome don’t respond to initial therapy with analgesics and need interventional therapy. Corticosteroid injection is the standard therapy. Prolotherapy has been demonstrated to be effective in other chronic pain syndromes, but not in CSP. The aim of this study was to determine the effectiveness of prolotherapy compared to local anesthetic injection in the treatment of chronic shoulder painMETHODSRetrospective and comparative study of 77 patients from the National Institute of Oncology in Mexico City who received treatment for Chronic Shoulder Pain guided by ultrasound between 2017-2019. 57 patients were kept in the study for further analysis. 39 received infiltration with corticosteroids and 17 prolotherapy. Effectiveness of therapies was determined based on the decrease in VAS score in next follow-up session. Statistical analysis were performed with SPSS and RStudio Software.RESULTS51% of patients with Chronic Shoulder Pain were unemployed. 84% of the patients needed 3 different types of analgesics before they received ultrasound guided local treatment. Prolotherapy was as efficient as local anesthetic injection, no matter basal pain severity or underlying shoulder diagnosis, despite prolotherapy being more used as treatment for Rotator Cuff Tendinopathy.CONCLUSIONSProlotherapy and corticosteroid injection guided by ultrasound have the same efficacy in pain relief for chronic shoulder pain in oncologic patients.

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