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
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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.
