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Shoulder pain

Physiotherapy or corticosteroid injection for shoulder pain?

D A W M van der Windt, L M Bouter

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The choice is not clear cut and patients’ expectations and preferences may affect the outcome

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Keywords: shoulder pain; physiotherapy; corticosteroids

The first 150 words of the full text of this article appear below.

In this issue Hay et al¹ report the results of a randomised clinical trial evaluating the effectiveness of physiotherapy and corticosteroid injection for patients with unilateral shoulder pain. Shoulder pain is a common complaint; estimates of the annual incidence in general practice vary from 6.6 to 25 cases per 1000 patients.^2–4 Most patients are treated in primary care. If treatment with analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) is not successful, patients with persistent symptoms are often referred for physiotherapy or treated with local infiltration of a corticosteroid.⁴ Until recently, evidence on the effectiveness of these interventions was scarce, particularly for primary care patients. Over the past few years two randomised trials have been published that directly compared the effects of physiotherapy with corticosteroid injections.^5,6 Both trials were carried out in Dutch general practice.

The trial by Hay et al adds important and relevant information to this existing evidence. . . . [Full text of this article]

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This article has been cited by other articles:

• Bal, A., Eksioglu, E., Gulec, B., Aydog, E., Gurcay, E., Cakci, A. (2008). Effectiveness of corticosteroid injection in adhesive capsulitis. Clin Rehabil 22: 503-512 [Abstract]  
• Vas, J., Ortega, C., Olmo, V., Perez-Fernandez, F., Hernandez, L., Medina, I., Seminario, J. M., Herrera, A., Luna, F., Perea-Milla, E., Mendez, C., Madrazo, F., Jimenez, C., Ruiz, M. A., Aguilar, I. (2008). Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology (Oxford) 47: 887-893 [Abstract] [Full Text]  
• Thomas, E, van der Windt, D A W M, Hay, E M, Smidt, N, Dziedzic, K, Bouter, L M, Croft, P R (2005). Two pragmatic trials of treatment for shoulder disorders in primary care: generalisability, course, and prognostic indicators. Ann Rheum Dis 64: 1056-1061 [Abstract] [Full Text]  
• Haahr, J P, Ostergaard, S, Dalsgaard, J, Norup, K, Frost, P, Lausen, S, Holm, E A, Andersen, J H (2005). Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 64: 760-764 [Abstract] [Full Text]  
• Kassimos, D G, Panayi, G, van der Windt, D A W M (2004). Differences in the management of shoulder pain between primary and secondary care in Europe: time for a consensus * Author's reply. Ann Rheum Dis 63: 111-112 [Full Text]  

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The Leader is biased

Frank J.J. Conijn

Ann Rheum Dis Online, 23 May 2003 [Full text]

Author's reply

Danielle A. van der Windt, et al.

Ann Rheum Dis Online, 21 Nov 2003 [Full text]