Physiotherapy and Steroids Similarly Effective for Shoulder Pain

By Amy Orciari Herman

For patients with shoulder impingement syndrome, physical therapy and corticosteroid injections offer similar relief, but injections lead to more healthcare utilization, according to an Annals of Internal Medicine study.

Some 100 adults with unilateral shoulder impingement syndrome at one military medical center were randomized to receive either subacromial injection of triamcinolone acetonide (40 mg; up to 3 injections over 1 year), or physical therapy (6 sessions over 3 weeks) plus home exercises.

At 1 year, both groups had achieved a 50% improvement in average pain and disability score, with no significant differences between the groups at any time during the study. However, the steroid group had more primary care visits for shoulder pain and more additional steroid injections than the physical therapy group.

Editorialists write: “In choosing a management plan, clinicians should consider patient preference, availability of practitioners, and other health care use… If the patient prefers a corticosteroid injection, its effectiveness, safety profile, and potential for additional health care should be discussed.”

  • Annals of Internal Medicine article (Free abstract)
  • Annals of Internal Medicine editorial (Subscription required)
  • Background: NEJM Journal Watch General Medicine summary on focused exercises for subacromial impingement syndrome (Your NEJM Journal Watch registration required)