Comparison of intra-articular injection therapy to physiotherapy techniques in management of shoulder impingement syndrome.
Background: Shoulder impingement syndrome is umbrella term that covers rotator cuff syndrome, tendinitis of muscles of rotator cuff and bursitis in shoulder region. Usually this syndrome is treated conservatively. The treatment options are corticosteroid injections, medical treatment and physical therapy, of which, the most common are injection therapy and physical therapy. Injection therapy is carried out by orthopedic surgeons. However, which treatment is most effective in terms of symptoms relieving and cost effectiveness, yet conflicting. Study Design: Randomized Controlled Trial. Setting: Independent University Hospital, Faisalabad. Period: 1stJuly 2017 to 30thJune 2018. Methods: Comparing effects of two treatments for shoulder impingement syndrome; sub armorial steroid injection, the control group and manual physical therapy, the treatment group. Primary outcomes were Shoulder Pain and Disability Index (SPADI), to measure endpoint differences. Secondary outcomes included changes in Global Rating of Change (GRC) scale and Numeric Pain Rating Scale (NPRS) scores. Trial was conducted in one clinical setup. The collected data was analyzed by Statistical Package of Social Sciences (SPSS 20.00). Results: At baseline of group physical therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At post treatment of group injection therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At follow up of group injection therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At follow up of treatment physical therapy all patients mild level of pain, at numeric rating pain scale. Conclusion: Injection therapy treatment is more effective in improving shoulder impingement syndrome in terms of pain and function than that of physical therapy treatment.