Evidence-Based Insights on Shoulder Injections introduction After previously comparing corticosteroids and examining common complications , we will now examine the evidence behind corticosteroid injections.
Evidence-Based Insights on Shoulder Injections introduction After previously comparing corticosteroids and examining common complications , we will now examine the evidence behind corticosteroid injections. Injections with depot corticosteroids are used by many to provide both therapeutic and diagnostic value. They can also serve to delay or possibly avoid the need for surgery in some situations.
Adhesive capsulitis Adhesive capsulitis commonly presents with progressive pain and limited range of motion. It can also occur overnight after a day of housework, painting or overhead lifting. It can affect 2-5 percent of the general population and up to 20% of diabetics.
It is generally self-limiting, but some patients have reported pain for up to 3 years. The goals of treatment include relieving pain and restoring motion and function. Common first line treatments include NSAIDs, physical therapy and corticosteroid injections.
Subacromial injections are widely used for treatment due to its cost-effectiveness and often quick partial relief of pain. Adhesive capsulitis is thought to be due to inflammation and corticosteroids are proposed to reduce synovitis, limit capsular fibrosis and alter the natural history of the disease. A review in 2012 compared the effectiveness of corticosteroids with physical therapy and found greater improvement in pain, ROM and shoulder disability after six weeks and one year, with a greater effect at six weeks.
A recent review in 2016 concluded that corticosteroid injections (mostly with triamcinolone 20 mg or 40 mg) outperformed physical therapy in regards to shoulder pain and function up to 12 weeks, but evidence for relief after 12 weeks has not been supported. Concluded that the use of an intra-articular corticosteroid injection (CSI) in addition to physical therapy showed greater improvement in pain and disability when compared to physical therapy or placebo at six weeks and three months, but this was not significant at six months. The use of physical therapy alone was found to be of limited benefit in this study.
If you are experiencing symptoms that may be related to evidence behind corticosteroid injections of the shoulder, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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