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AB0165 The efficacy of corticosteroid infiltration and physiotherapy in painful shoulder
  1. M Bonilla-Hernán1,
  2. P Aguado1,
  3. E De Miguel-Mendieta1,
  4. F Diaz2,
  5. A Villalba-Yllan1,
  6. E Martín-Mola1
  1. 1Rheumatology
  2. 2Rehabilitation, Hospital, Madrid, Spain

Abstract

Background The efficacy of coticosteroid infiltration and physiotherapy in painful shoulder.

Objectives To analyse the efficacy of corticosteroid infiltration versus physiotherapy in painful shoulder.

Methods We studied 36 consecutive patients with painful shoulder (mean age 59 years, range 33–79;29 females, 7 males) without inflammatory arthropaty or traumatic events. All patients were evaluated by a clinical protocol that included: pain scale, range of joint motion, shoulder pain disability index (SPADI), ASES cumulative ADL score (ASES), and ultrasonography exploration at basal visit and at the end of treatment. Patients were treated either with steroidal injection (n = 18) or physiotherapy including electrotherapy and exercises (n = 18). Patients, in both groups, were allow to take analgesics or NSAIDs. Statistical assay was done with paired t-student test and Wilcoxon test.

Results Infiltration therapy improved pain scale***, abduction**, flexion***, external rotation***, SPADI***, ASES*** and ultrasonographic thickness of biceps tendon*, infraspinous tendon*, subacromio-subdeltoid bursitis* and acromioclavicular joint*. Phisiotherapy improved extension**, external rotation***, ASES* and thickness of supraspinatus tendon*** by ultrasonography. When we studied only patients with ultrasonographic findings of tendinits (n = 25), infiltration (13) improved pain scale**, abbduction**, flexion**, external rotation***, SPADI*** and ASES***, however physiotherapy (n = 12) only improved external rotation***. In patients who had tendinous tears (n = 12), statistical analysis was not significant.

Conclusion Steroidal infiltration has been shown to be more efficacious than physiotherapy when several parameters like pain, range of motion and functional capacity, were measured.

*p < 0.05,**p < 0.01,***p < 0.001.

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