Corticosteroid therapy versus physiotherapy on pain, mobility and function in shoulder impingement: A short note.
Natalie Benjamin-Damons, Naeema A R Hussein El Kout, Rogier van Bever Donker and 2 others
PMID 36569457WHAT IT FOUND
For subacromial shoulder impingement, both steroid injection and physiotherapy improved pain, movement and function.
Steroid injection may help function more at 6 to 7 weeks, but at 6 months and 12 months there was no clear advantage for steroid injection.
Key findings
01Physiotherapy programmes and corticosteroid injection both improved pain, shoulder range of motion and shoulder function in the short term, medium term and long term.
02At 6 to 7 weeks, shoulder function favoured corticosteroid injection, but there was no evidence of superiority for pain or range of motion over 1 to 3 months.
03At 6 months and 12 months, there was no evidence that corticosteroid injection was superior to physiotherapy for shoulder function, pain or range of motion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 3 randomised controlled trials met the inclusion criteria. The steroid injections and physiotherapy programmes varied between studies. The pain and range-of-motion results could not be pooled because the studies differed substantially. The overall evidence was graded moderate because of indirectness of treatment. The recommendation was weak and may change because few studies are available.
The easy way to misread this
Do not conclude that steroid injection is better overall. Its advantage was only for shoulder function at 6 to 7 weeks, and at 6 months and 12 months there was no evidence it was superior to physiotherapy.