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Related Experiment Videos

Corticosteroid injections for shoulder pain.

R Buchbinder1, S Green, J M Youd

  • 1Department of Clinical Epidemiology, Cabrini Hospital and Monash Unversity, Suite 41, Cabrini Medical Centre, 183 Wattletree Rd, Malvern, Victoria, Australia, 3144. rachelle.buchbinder@med.monash.edu.au

The Cochrane Database of Systematic Reviews
|January 22, 2003
PubMed
Summary

Corticosteroid injections for shoulder pain show limited proven efficacy. Subacromial injections for rotator cuff disease and intra-articular injections for adhesive capsulitis may offer small, short-term benefits.

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Area of Science:

  • Orthopedics and Sports Medicine
  • Rheumatology
  • Pain Management

Background:

  • Shoulder pain is a common ailment with numerous proposed treatments.
  • Corticosteroid injections are frequently recommended for shoulder pain relief.
  • Evidence for the efficacy of many shoulder pain treatments, including corticosteroid injections, is limited.

Purpose of the Study:

  • To evaluate the efficacy and safety of corticosteroid injections for treating shoulder pain in adults.
  • To synthesize evidence from randomized controlled trials on corticosteroid injections for various shoulder conditions.

Main Methods:

  • Systematic review and meta-analysis of randomized and pseudo-randomized controlled trials.
  • Searched multiple databases (MEDLINE, EMBASE, CINAHL, Central, Science Citation Index) up to June 2002.

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  • Included trials comparing corticosteroid injections to placebo or other interventions in adults with shoulder pain, excluding specific conditions like rheumatoid arthritis and fractures.

    • Main Results:

    • Twenty-six trials were included, exhibiting significant variability in injection parameters and methodological quality.
    • Subacromial corticosteroid injections showed a small benefit over placebo for rotator cuff disease but no advantage over NSAIDs.
    • Intra-articular injections suggested potential early benefit for adhesive capsulitis over placebo and short-term benefit over physiotherapy in one trial.

    Conclusions:

    • Despite numerous trials, small sample sizes and methodological heterogeneity limit definitive conclusions on corticosteroid injection efficacy for shoulder pain.
    • Subacromial and intra-articular corticosteroid injections may provide modest, potentially short-lived benefits for specific shoulder conditions.
    • Further high-quality research is needed to clarify optimal techniques, dosages, and the influence of needle placement accuracy on outcomes.