Comparison of the efficacy of local corticosteroid injection and physical therapy on pain severity, joint range of motion and muscle strength in patients with shoulder impingement syndrome referred to Rasool-e-Akram Medical Center from April 2008 to September 2009

ABSTRACT

Subacromial impingement is a common cause of shoulder pain and many patients with this condition recover with conservative management. The most commonly used modalities of non-operative treatment include activity modification, anti-inflammatory medication and subacromial injection of steroid and ultrasound and physical therapy programs. This study assessed the value of physiotherapy versus subacromial corticosteroid injection in patients with shoulder impingement syndrome [SIS]. Seventy three patients with SIS enrolled in the study and treated through physiotherapy [n=37] and subacromial corticosteroid injection [n=36]. Two follow-up sessions accomplished at the end of 4[th] week and 3[rd] month of treatment respectively. Corticosteroid injection caused dramatic improvement in the painful state [p<0.0001] and sleep dysfunction score [p=0.039] in the first follow-up. However, physiotherapy showed significantly better results regarding patients' pain score [p=0.016] and their shoulder join range of motions [p=0.017 and p=0.029 for the abduction and extension, respectively] in their second follow-up. Our study results showed that subacromial corticosteroid injection primarily resulted in more improvement in the impingement symptoms. However, with the long-term follow-up the results were better for the physiotherapy. These results suggest that patients should not undergo surgery before having conservative treatment