Steroid injections are a common treatment for chronic shoulder pain. If you are like many people, you are probably not too fond of needles. A new study, which state the physiotherapy exercise is as effective as steroid shots, might come as music to your ears.
Shoulder Impingement Syndrome
Untreated tendonitis, bursitis or other inflammation in the shoulder joint can eventually lead to a painful condition called shoulder impingement syndrome. This elusive syndrome does not have a standardized treatment method, so doctors often prescribe the one thing that alleviates the pain: Steroid injections. These shots reduce the inflammation, and thereby alleviate the pain.
The Research Team
Lead author Daniel I. Rhon – a physiotherapist at the Center for the Intrepid at Brooke Army Medical Center in Fort Sam Houston, Texas – recruited a team of researchers, who compared the two types of treatments. Rhon and his team randomly divided 104 patients with shoulder impingement syndrome into two groups. One group received physiotherapy twice a week for three weeks. The physiotherapists evaluated the patients’ muscle weakness, mobility and pain. Based on their assessments, they prescribed a series of stretches, contract-relax techniques and shoulder stability exercises for the upper spine area. They gave the patients a series of exercises to perform at home.
Patients in the other group received up to three injections of corticosteroids over the course of a year. Although they did not attend physiotherapy sessions, they did receive printed instructions for a therapeutic, at-home exercise program.
Both groups showed a significant reduction in pain after one month. They experienced reduced pain for the entire length of the one year study. As noted the study featured in the Annals of Internal Medicine, both treatments reduced the patients’ pain scores by half. However, by the end of the year, 60 percent of the members of the steroid injection group had returned to their primary care doctor for shoulder pain again. On contrast, only 37 percent of the physiotherapy group returned for further injections.
The Aussie Perspective
Brooke K. Coombes, a student of rehabilitation medicine in the physiotherapy department of the University of Queensland in Brisbane, Australia, coauthored an editorial on the study. She was not surprised at the outcomes of the study.
“Physical therapy involves more patient-clinician contact than a single consultation at which an injection is given,” she said. “This may allow for advice or reassurance about the condition and self-management approaches.”
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