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To evaluate the comparison of the efficacy of corticosteroid injections to local anaesthetic injections in the treatment of RCRSP.
Rotator cuff-related
shoulder pain (RCRSP) is a subacromial pain syndrome resulted in altered
processing and output of the central nervous system. Although corticosteroid
(CS) injections were prescribed for RCRSP, the definitive mechanism of action
is uncertain, and no previous review has directly compared CS alone with local
anesthetic-alone injections in the treatment of RCRSP. Therefore, the results
of this study revealed that CS injections might have a short-term benefit (up
to 8 weeks) over local anesthetic injections alone in the management of RCRSP.
To
evaluate the comparison of the efficacy of corticosteroid injections to local
anaesthetic injections in the treatment of RCRSP.
The
search engines like CINAHL Plus, EMBASE,
PubMed, Cochrane, and PEDro were searched from inception to 8 June 2017. The
reference lists of related studies were also searched manually. The eligibility
was evaluated by two reviewers independently. The randomised controlled trials
(RCTs) involved comparison of subacromial injections of corticosteroid with
anaesthetic injections were selected for the analysis. Two reviewers
individually derived the information regarding short-term, midterm and
long-term results for pain, patient-perceived improvement, range of motion, and
self-reported function.
A
total of 13 RCTs were selected, out of which the four trials were found to have
a low risk of bias. The use of
corticosteroid over anaesthetic-only injections in the short term was favoured
by three studies having a low risk of bias. Substantial evidence was noticed
regarding the similarity between the midterm outcomes of both the injection
types. However, evidence regarding the similarity between the long-term results
of both the injection types was minimal.
As per
findings, Corticosteroid injections alone exert short-term advantages over
local anaesthetic injections during RCRSP management and no evidence of
corticosteroid advantage over local anaesthetic injections was seen beyond
eight weeks.
Br J Sports Med. 2018 Jan 5
Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review
Tim Cook et al.
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