Abstract
Objective
To present an evidence-based overview of the effectiveness of pharmaceutical interventions,
including nonsteroidal anti-inflammatory drugs, corticosteroid injections, and other
injections, used to treat the subacromial impingement syndrome (SIS). An overview
can help physicians select the most appropriate pharmaceutical intervention, and it
can identify gaps in scientific knowledge.
Data Sources
The Cochrane Library, PubMed, Embase, PEDro, and CINAHL databases.
Study Selection
Two reviewers independently selected relevant reviews and randomized clinical trials.
Data Extraction
Two reviewers independently extracted the data and assessed the methodologic quality.
Data Synthesis
A best evidence synthesis was used to summarize the results. Three reviews and 5 randomized
clinical trials were included. Although we found limited evidence for effectiveness
in favor of 2 sessions with corticosteroid injections versus 1 session, for the effectiveness
of corticosteroid injections versus placebo, nonsteroidal anti-inflammatory drugs,
or acupuncture, only conflicting and no evidence for effectiveness was found. Moderate
evidence was found in favor of immediate release oral ibuprofen compared with sustained-released
ibuprofen in the short-term. Also, moderate evidence for effectiveness was found in
favor of glyceryltrinitrate patches versus placebo patches in the short-term and mid
term. Furthermore, injections with disodium ethylene diamine tetraacetic acid plus
ultrasound with ethylene diamine tetraacetic acid gel were more effective (moderate
evidence) than was placebo treatment in the short- and long-term.
Conclusions
This article presents an overview of the effectiveness of pharmaceutical interventions
for SIS. Some treatments seem to be promising (moderate evidence) to treat SIS, but
more research is needed before firm conclusions can be drawn.
Keywords
List of abbreviations:
CANS (Complaints of the Arm, Neck, and/or Shoulder), CI (confidence interval), EDTA (ethylene diamine tetraacetic acid), GTN (glyceryltrinitrate), NSAIDs (nonsteroidal anti-inflammatory drugs), RCT (randomized clinical trial), ROM (range of motion), SIS (subacromial impingement syndrome)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Multidisciplinary consensus on the terminology and classification of complaints of the arm, neck and/or shoulder.Occup Environ Med. 2007; 64: 313-319
- Prevalence and characteristics of complaints of the arm, neck, and/or shoulder (CANS) in the open population.Clin J Pain. 2008; 24: 253-259
- Associations between work-related factors and specific disorders of the shoulder – a systematic review of the literature.Scand J Work Environ Health. 2010; 36: 189-201
- Shoulder disorders in general practice: incidence, patient characteristics, and management.Ann Rheum Dis. 1995; 54: 959-964
- Shoulder impingement syndrome.Am J Med. 2005; 118: 452-455
Nederlands Huisartsen Genootschap (NHG) Standaard Schouderklachten: the Netherlands; 2008.
- A manual physical therapy approach versus subacromial corticosteroid injection for treatment of shoulder impingement syndrome: a protocol for a randomised clinical trial.BMJ Open. 2011;
- Peri-articular injection of tenoxicam for painful shoulders: a double-blind, placebo controlled trial.Clin Rheumatol. 1996; 15: 604-609
- Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome?.Clin Rheumatol. 2004; 23: 496-500
- Effectiveness of treatment of calcific tendinitis of the shoulder by disodium EDTA.Arthritis Rheum. 2009; 61: 84-91
- Comparison of two ibuprofen formulations in the treatment of shoulder tendonitis.Clin Rheumatol. 1992; 11: 105-108
- Topical glyceryl trinitrate application in the treatment of chronic supraspinatus tendinopathy: a randomized, double-blinded, placebo-controlled clinical trial.Am J Sports Med. 2005; 33: 806-813
- 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group.Spine (Phila Pa 1976). 2009; 34: 1929-1941
- Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group.Spine (Phila Pa 1976). 2003; 28: 1290-1299
- Physiotherapy interventions for shoulder pain.Cochrane Database Syst Rev. 2003; : CD004258
- Acupuncture for shoulder pain.Cochrane Database Syst Rev. 2005; : CD005319
- Corticosteroid injections for shoulder pain.Cochrane Database Syst Rev. 2003; : CD004016
- Clinical study comparing acupuncture, physiotherapy, injection and oral anti-inflammatory therapy in shoulder-cuff lesions.Curr Med Res Opin. 1980; 7: 121-126
- Low power laser therapy of shoulder tendonitis.Scand J Rheumatol. 1989; 18: 427-431
- A prospective double blind dummy placebo controlled study comparing triamcinolone hexacetonide injection with oral diclofenac 50 mg TDS in patients with rotator cuff tendinitis.J Rheumatol. 1990; 17: 1207-1210
- Efficacy of injections of corticosteroids for subacromial impingement syndrome.J Bone Joint Surg Am. 1996; 78: 1685-1689
- Randomized, double-blind, placebo-controlled study of the treatment of the painful shoulder.Arthritis Rheum. 1987; 30: 1040-1045
- A double-blind trial comparing subacromial methylprednisolone and lignocaine in acute rotator cuff tendinitis.Br J Rheumatol. 1993; 32: 743-745
- [Long-term therapeutic effect of different intra-articular injection treatments of the painful shoulder–effect on pain, mobility and work capacity] [German].Rehabilitation (Stuttg). 1996; 35: 176-178
- A placebo-controlled trial of steroid injections in the treatment of supraspinatus tendonitis.Scand J Rheumatol. 1985; 14: 76-78
- A double-blind study of the effectiveness of low level laser treatment of rotator cuff tendinitis.Br J Rheumatol. 1993; 32: 740-742
- Ultrasound therapy for calcific tendinitis of the shoulder.N Eng J Med. 1999; 340: 1533-1538
- Pulsed ultrasound treatment of the painful shoulder: a randomized, double–blind, placebo–controlled study.Scand J Rehabil Med. 1995; 27: 105-108
- The efficacy of low level laser therapy in supraspinatus tendinitis.Clin Rehabil. 1995; 9: 126-134
- The effect of mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome.J Orthop Sports Phys Ther. 1998; 28: 3-14
- [Trattamento della periartrite calcarea di spalla con campi magnetici pulsanti: studio controllato] [Italian].La Riabilitazione. 1990; 23: 27-33
- Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome.J Orthop Sports Phys Ther. 2000; 30: 126-137
- Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease.BMJ. 1993; 307: 899-903
- Acetic acid iontophoresis and ultrasound for the treatment of calcifying tendinitis of the shoulder: a randomized control trial.Arch Phys Med Rehabil. 1997; 78: 379-384
- Rotator cuff tendinitis: comparison of subacromial injection of a long acting corticosteroid versus oral indomethacin therapy.J Rheumatol. 1986; 13: 608-613
- Carpal tunnel syndrome, part I: effectiveness of nonsurgical treatments–a systematic review.Arch Phys Med Rehabil. 2010; 91: 981-1004
- Effectiveness of interventions of specific complaints of the arm, neck, and/or shoulder: 3 musculoskeletal disorders of the hand. An update.Arch Phys Med Rehabil. 2010; 91: 298-314
- In organic chemistry.Academic Press, San Diego2001
Article info
Publication history
Published online: December 13, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
