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Treatment of shoulder pain
  1. A N Bamji1
  1. 1Queen Mary’s Hospital Frognal Avenue, Sidcup, UK
  1. Correspondence to:
    Dr A N Bamji;

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Hay and colleagues concluded, in their extended report of a trial of physiotherapy and injection for unilateral shoulder pain that physiotherapy and local steroid injection are of similar effectiveness.1 They suggest that “The high overall success rates... argue against the need for further exploratory trials in this condition”. I disagree. A large number of studies of shoulder pain have been bedevilled by diagnostic criteria that are not precise,2 and this study must unfortunately join the others.

Unilateral shoulder pain has a number of different causes. The study by Hay excludes a few specific conditions—in particular, a ruptured rotator cuff, but must by definition include a heterogeneous group of problems that are in fact quite discrete. These include frozen shoulder (adhesive capsulitis), rotator cuff injuries without full …

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