Steroid injections are more effective than physiotherapy in treating shoulder pain

Both corticosteroid injections and physiotherapy are commonly used to treat shoulder pain but there is little evidence to support their effectiveness. In a randomised trial carried out in primary care Van der Windt et al (p 1292) compared the effectiveness of injections with the effectiveness of physiotherapy in 109 patients with painful stiff shoulder. The difference in improvement between the groups favoured those treated with injections. The differences were mainly the faster relief of pain and disability in patients treated with injections. Follow up assessment at 6 and 12 months showed comparatively small differences between the groups. Adverse reactions were generally mild, but doctors should be aware of the potential side effects of injection, particularly in women. The authors conclude that injections should be the preferred method for the initial treatment of painful stiff shoulder.


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Relevant Article

Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial

D A W M van der Windt, B W Koes, W Devillé, A J P Boeke, B A de Jong, and L M Bouter
BMJ 1998 317: 1292-1296. [Abstract] [Full Text] [PDF]