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Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial

Year 2021, Volume: 38 Issue: 4, 511 - 515, 09.10.2021

Abstract

Objectives:

The aim of this randomized trial was to evaluate the efficacy of subacromial corticosteroid injection and physical therapy (PT) in patients with subacromial impingement syndrome (SIS).

Patients and Methods:

Forty patients who diagnosed as SIS were included in this study and were randomly assigned to the PT and injection groups. Pain during rest, sleep and motion were evaluated by visual analog scale (VAS). Disability was determined by Costant-Murley score. Physical and social functions were evaluated with Short Form-36 (SF-36). Active range of motion (ROM) was measured by goniometer. Patients were evaluated at baseline, 3rd and 8th weeks of the therapy. PT continued for 3 weeks with ultrasound and interferential current combined to local heat and exercise. For patients in the injection group, a single steroid injection of 40 mg triamcinolone acetonide into the subacromial space was combined with exercise.

Results:

After 8 weeks, significant improvements at pain, SF-36 and Costant-Murley scores were observed in both groups (p<0.001). Improvement rates of pain during sleep and motion were significantly higher in PT group than the injection group after 8 weeks (p<0.01). Significant improvements were determined at ROM in both groups (p<0.001). No statistical significant differences were found between two groups in terms of Costant-Murley and ROM scores. Results of the PT group were significantly better in terms of physical and social function, and pain subscores of SF-36 (p<0.05).

Conclusion:

Our results suggest that both PT and corticosteroid injection have beneficial effects on shoulder mobility and pain relief in SIS. PT should be an alternative and effective treatment method to corticosteroid injection in SIS.

Thanks

Dear Editor, We are sending our manuscript to your journal after all the authors have seen and approved the final form of it. We have not published it elsewhere before and the manuscript is not being considered simultaneously in another journal. The authors also declare no conflict of interest. We do look forward to hearing from you soon. Best wishes,

References

  • 1) Neer CS. Impingement lesions Clin Orthop 1984;173:70-77
  • 2) Garving C, Jakob S, Bauer I et al. Impingement Syndrome of the Shoulder. Dtsch Arztebl Int. 2017;114(45):765–776
  • 3) Dong W, Goost H, Lin XB et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis [published correction appears in Medicine (Baltimore). 2016;95(23):96.
  • 4) Clark SC, Jones MW, Choudhury RR, Smith E. Bilateral patellar tendon rupture secondary to repeated local steroid injections. J Accid Emerg Med. 1995;12(4):300–301.
  • 5) Imran M, Arshad N, Ibrahim S et al . Effects of Therapeutic Funding Ultrasound and Manual Physiotherapy in Shoulder Impingement Syndrome in Volleyball Players. JIMDC. 2017; 6(3):179-183
  • 6) Constant CR, Murley AHG. A clinical method of functional assesment of the shoulder. Clin Orthop 1987;215:160-164
  • 7) Koçyiğit H, Aydemir O, Fişek G. Turkish validty and reliability of Short Form 36. Drug and Treatment 1999:12;102-106
  • 8) Kul A, Ugur M. Comparison of the Efficacy of Conventional Physical Therapy Modalities and Kinesio Taping Treatments in Shoulder Impingement Syndrome. Eurasian J Med. 2019;51(2):139–144.
  • 9) Koester MC ,George MS, Kuhn JE. Shoulder Impingement Syndrome The American Journal of Medicine 2005; 118: 452– 455
  • 10) Miller DL, Smith NB, Bailey MR, et al. Overview of therapeutic ultrasound applications and safety considerations. J Ultrasound Med. 2012;31(4):623–634.
  • 11) Gürsel YK,Ulus Y, Bilgiç A et al. Adding Ultrasound in the Management of Soft Tissue Disorders of the Shoulder: A Randomized Placebo-Controlled Trial. Physical Therapy 2004;84 (4):336–343
  • 12) Ainsworth, R., Dziedzic, K., Hiller, L et al. A prospective double blind placebo-controlled randomized trial of ultrasound in the physiotherapy treatment of shoulder pain. Rheumatology 2007; 46 (5): 815-20
  • 13) Yildirim MA, Ones K, Celik EC. Comparision of Ultrasound Therapy of Various Durations in The Treatment of Subacromial Impingement Syndrome. J Phys Ther Sci 2013;25(9):1151–1154.
  • 14) Bicer A, Özışık S, Akşit sc et al. Comparison of Local Cortıcosteroid Injectıon and Conventıonal Physıcal Therapy In Management of The Painful Shoulder. Turkiye Klinikleri J Med Sci. 2005;25(4):506-12
  • 15) Tan K, Özgül A ,Kalyon T, et al, Omuz Sıkışma Sendromunda Konvansiyonel Fizik Tedavi ile Steroid Enjeksiyonunun Karşılaştırılması. Türk Fiz Tıp ve Rehab Derg 2002; 48:27-32
  • 16) Levendoğlu F, Yılmaz H, Uğurlu H. Comparıson The Effectiveness of Physical Therapy and Corticosteroid Injectıon for subacromial Impingement syndrome. Arch Rheumatol 2005;20:1-7
  • 17) Blair B , Rokito AS, Cuorno F et al . Efficacy of Injections of Corticosteroids for Subacromial Impingement Syndrome. J Bone Joint Surg 1996;78:1885-1689
  • 18) Sperber K . Joint and Soft Tissue Injection. In: Tan JC, Ed. Practical Manual of Physical Medicine and Rehabilitation 2006; 413-427
  • 19) Goats GC .Interferential Current Therapy. Br J Sp Med 1990 ;24(2):87-92
  • 20) Ganne JM. Stimulation of Bone Healing with Interferantial Therapy. Aust J Physiother 1988;34(1):9-20
  • 21) Dimitrijevic IM,Lazovic MP, Kocic MN et al. Effects of Low - Level Laser Therapy and Interferantial Current Terapy In the Treatment of Complex Regional Pain Syndrome. Turk J Phys Med Rehab 2014;60:98-105
  • 22) Fredorczyk J. The Role of Physical Agents in Modulating Pain. J Hand Ther 1997; 10:110-121
  • 23) Ay S ,Doğan SK. Comparison of Efficacy of Different Analgesic Currents in Patients with Shoulder Pain. S.D.Ü. Tıp Fak. Derg. 2009;16(3):1-5
  • 24) Facci LM, Nowotny Jp, Tormem F et al. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Currents (IFC) in Patients with Nonspecific Chronic Low Back Pain: Randomized Clinical Trial . Sao Paulo Med J.2011;129(4):206-16
  • 25) Ucurum SG, Kaya DÖ, Kayali Y et al. Comparison of Different Electrotherapy Methods and Exercise Therapy in Shoulder Impingement Syndrome : A Prospective Randomised Controlled Trial. Acta Orthop Traumatol Turc. 2018;52:258-255
Year 2021, Volume: 38 Issue: 4, 511 - 515, 09.10.2021

Abstract

References

  • 1) Neer CS. Impingement lesions Clin Orthop 1984;173:70-77
  • 2) Garving C, Jakob S, Bauer I et al. Impingement Syndrome of the Shoulder. Dtsch Arztebl Int. 2017;114(45):765–776
  • 3) Dong W, Goost H, Lin XB et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis [published correction appears in Medicine (Baltimore). 2016;95(23):96.
  • 4) Clark SC, Jones MW, Choudhury RR, Smith E. Bilateral patellar tendon rupture secondary to repeated local steroid injections. J Accid Emerg Med. 1995;12(4):300–301.
  • 5) Imran M, Arshad N, Ibrahim S et al . Effects of Therapeutic Funding Ultrasound and Manual Physiotherapy in Shoulder Impingement Syndrome in Volleyball Players. JIMDC. 2017; 6(3):179-183
  • 6) Constant CR, Murley AHG. A clinical method of functional assesment of the shoulder. Clin Orthop 1987;215:160-164
  • 7) Koçyiğit H, Aydemir O, Fişek G. Turkish validty and reliability of Short Form 36. Drug and Treatment 1999:12;102-106
  • 8) Kul A, Ugur M. Comparison of the Efficacy of Conventional Physical Therapy Modalities and Kinesio Taping Treatments in Shoulder Impingement Syndrome. Eurasian J Med. 2019;51(2):139–144.
  • 9) Koester MC ,George MS, Kuhn JE. Shoulder Impingement Syndrome The American Journal of Medicine 2005; 118: 452– 455
  • 10) Miller DL, Smith NB, Bailey MR, et al. Overview of therapeutic ultrasound applications and safety considerations. J Ultrasound Med. 2012;31(4):623–634.
  • 11) Gürsel YK,Ulus Y, Bilgiç A et al. Adding Ultrasound in the Management of Soft Tissue Disorders of the Shoulder: A Randomized Placebo-Controlled Trial. Physical Therapy 2004;84 (4):336–343
  • 12) Ainsworth, R., Dziedzic, K., Hiller, L et al. A prospective double blind placebo-controlled randomized trial of ultrasound in the physiotherapy treatment of shoulder pain. Rheumatology 2007; 46 (5): 815-20
  • 13) Yildirim MA, Ones K, Celik EC. Comparision of Ultrasound Therapy of Various Durations in The Treatment of Subacromial Impingement Syndrome. J Phys Ther Sci 2013;25(9):1151–1154.
  • 14) Bicer A, Özışık S, Akşit sc et al. Comparison of Local Cortıcosteroid Injectıon and Conventıonal Physıcal Therapy In Management of The Painful Shoulder. Turkiye Klinikleri J Med Sci. 2005;25(4):506-12
  • 15) Tan K, Özgül A ,Kalyon T, et al, Omuz Sıkışma Sendromunda Konvansiyonel Fizik Tedavi ile Steroid Enjeksiyonunun Karşılaştırılması. Türk Fiz Tıp ve Rehab Derg 2002; 48:27-32
  • 16) Levendoğlu F, Yılmaz H, Uğurlu H. Comparıson The Effectiveness of Physical Therapy and Corticosteroid Injectıon for subacromial Impingement syndrome. Arch Rheumatol 2005;20:1-7
  • 17) Blair B , Rokito AS, Cuorno F et al . Efficacy of Injections of Corticosteroids for Subacromial Impingement Syndrome. J Bone Joint Surg 1996;78:1885-1689
  • 18) Sperber K . Joint and Soft Tissue Injection. In: Tan JC, Ed. Practical Manual of Physical Medicine and Rehabilitation 2006; 413-427
  • 19) Goats GC .Interferential Current Therapy. Br J Sp Med 1990 ;24(2):87-92
  • 20) Ganne JM. Stimulation of Bone Healing with Interferantial Therapy. Aust J Physiother 1988;34(1):9-20
  • 21) Dimitrijevic IM,Lazovic MP, Kocic MN et al. Effects of Low - Level Laser Therapy and Interferantial Current Terapy In the Treatment of Complex Regional Pain Syndrome. Turk J Phys Med Rehab 2014;60:98-105
  • 22) Fredorczyk J. The Role of Physical Agents in Modulating Pain. J Hand Ther 1997; 10:110-121
  • 23) Ay S ,Doğan SK. Comparison of Efficacy of Different Analgesic Currents in Patients with Shoulder Pain. S.D.Ü. Tıp Fak. Derg. 2009;16(3):1-5
  • 24) Facci LM, Nowotny Jp, Tormem F et al. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Currents (IFC) in Patients with Nonspecific Chronic Low Back Pain: Randomized Clinical Trial . Sao Paulo Med J.2011;129(4):206-16
  • 25) Ucurum SG, Kaya DÖ, Kayali Y et al. Comparison of Different Electrotherapy Methods and Exercise Therapy in Shoulder Impingement Syndrome : A Prospective Randomised Controlled Trial. Acta Orthop Traumatol Turc. 2018;52:258-255
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Cengizhan Doğan 0000-0002-8152-6770

Sertaç Ketenci 0000-0002-2950-8778

Bora Uzuner 0000-0001-9498-0289

Halil Erdinç Şen 0000-0002-4326-348X

Ayhan Bilgici 0000-0002-7854-314X

Gamze Alaylı 0000-0003-0194-0275

Ömer Kuru 0000-0002-7454-4647

Publication Date October 9, 2021
Submission Date March 22, 2021
Acceptance Date April 8, 2021
Published in Issue Year 2021 Volume: 38 Issue: 4

Cite

APA Doğan, C., Ketenci, S., Uzuner, B., Şen, H. E., et al. (2021). Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial. Journal of Experimental and Clinical Medicine, 38(4), 511-515.
AMA Doğan C, Ketenci S, Uzuner B, Şen HE, Bilgici A, Alaylı G, Kuru Ö. Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial. J. Exp. Clin. Med. October 2021;38(4):511-515.
Chicago Doğan, Cengizhan, Sertaç Ketenci, Bora Uzuner, Halil Erdinç Şen, Ayhan Bilgici, Gamze Alaylı, and Ömer Kuru. “Comparison of Subacromial Corticosteroid Injection and Physical Therapy in Patients With Subacromial Impingement Syndrome: A Prospective, Randomized Trial”. Journal of Experimental and Clinical Medicine 38, no. 4 (October 2021): 511-15.
EndNote Doğan C, Ketenci S, Uzuner B, Şen HE, Bilgici A, Alaylı G, Kuru Ö (October 1, 2021) Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial. Journal of Experimental and Clinical Medicine 38 4 511–515.
IEEE C. Doğan, “Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial”, J. Exp. Clin. Med., vol. 38, no. 4, pp. 511–515, 2021.
ISNAD Doğan, Cengizhan et al. “Comparison of Subacromial Corticosteroid Injection and Physical Therapy in Patients With Subacromial Impingement Syndrome: A Prospective, Randomized Trial”. Journal of Experimental and Clinical Medicine 38/4 (October 2021), 511-515.
JAMA Doğan C, Ketenci S, Uzuner B, Şen HE, Bilgici A, Alaylı G, Kuru Ö. Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial. J. Exp. Clin. Med. 2021;38:511–515.
MLA Doğan, Cengizhan et al. “Comparison of Subacromial Corticosteroid Injection and Physical Therapy in Patients With Subacromial Impingement Syndrome: A Prospective, Randomized Trial”. Journal of Experimental and Clinical Medicine, vol. 38, no. 4, 2021, pp. 511-5.
Vancouver Doğan C, Ketenci S, Uzuner B, Şen HE, Bilgici A, Alaylı G, Kuru Ö. Comparison of subacromial corticosteroid injection and physical therapy in patients with subacromial impingement syndrome: A prospective, randomized trial. J. Exp. Clin. Med. 2021;38(4):511-5.