Powley, Andrew (2023) The Comparative Effectiveness of Sub-Acromial Corticosteroid Injection and Physiotherapy for Musculoskeletal Shoulder Pain: A Systematic Review. Masters thesis, Teesside University.

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Abstract

Background
Shoulder pain is a common presentation in primary care with an estimated UK prevalence of anywhere between 6.9% and 20%. There is currently a lack of evidence about the efficacy of the most commonly used interventions in treating shoulder pain such as Corticosteroid injection and Physiotherapy. It has also been seen that the tests used to diagnose shoulder pain is a failed paradigm and that patients should be sub-grouped based on a pragmatic design and by easily identifiable symptoms rather than given specific labels which does not aid in the treatment process.
Objective
To compare the efficacy of Sub-Acromial Corticosteroid injections and Physiotherapy modalities as treatments for musculoskeletal shoulder pain in the short, medium, and long term.
Outcome measures
The primary outcome measure was shoulder functional disability as measured by a patient reported outcome tool. The secondary outcome measure was pain intensity as measured by a visual analogue scale.
Results
Both interventions produced significant improvements over baseline at all time points for both outcome measures. There was some evidence that there was a trend towards exercise based Physiotherapy interventions for the primary outcome measure in the short and medium term. However, this trend seemed to disappear at long term follow-up. There was also some low quality evidence to support the use of Corticosteroid injection in the early phases of treatment for the secondary outcome measure and Physiotherapy for the medium to long term follow-up.
Conclusion
Both Sub-Acromial Corticosteroid injection and Physiotherapy significantly improves function and decreases pain in subjects with shoulder pain, but methodological shortcomings meant no firm conclusions could be made to establish if one treatment was significantly superior to the other. The effectiveness of Sub-Acromial Corticosteroid injection was similar to that of Physiotherapy interventions in subjects with shoulder pain.

Item Type:	Thesis (Masters)
Status:	Unpublished
Subjects:	R Medicine > RM Therapeutics. Pharmacology > RM695 Physical therapy. Occupational therapy
School/Department:	School of Science, Technology and Health
Institutes:	Institute for Health and Care Improvement
URI:	https://ray.yorksj.ac.uk/id/eprint/8936

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