Related Experiment Video
Updated: Aug 12, 2026
05:17
Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source
Published on: December 23, 2022
Corticosteroid Dose and Efficacy in Shoulder Impingement Syndrome: A Systematic Review and Meta-Analysis
Yihang Qin1, Hana H Kim2, Donna Gao3
1Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada.
American Journal of Physical Medicine & Rehabilitation
|August 11, 2026
Summary
Corticosteroid dose does not significantly impact pain or function outcomes for shoulder impingement syndrome (SIS) treated with subacromial injections. Lower doses may offer comparable benefits, suggesting a potential therapeutic ceiling effect.
Area of Science:
- Orthopedics
- Rheumatology
- Pharmacology
Background:
- Shoulder impingement syndrome (SIS) is a common cause of shoulder pain.
- Subacromial corticosteroid injections are a frequent treatment for SIS.
- The optimal corticosteroid dose for subacromial injections remains unclear.
Purpose of the Study:
- To determine if corticosteroid dose influences pain and functional outcomes in patients with SIS.
- To assess the dose-response relationship of subacromial corticosteroid injections.
Main Methods:
- Systematic review and meta-analysis of 23 studies including 739 patients.
- Searched six major databases from inception to July 2025.
- Utilized random-effects meta-analysis and meta-regression to analyze dose-outcome associations.
Main Results:
- No significant association was found between corticosteroid dose (below vs. 40 mg equivalent) and pain improvement (VAS).
- Pooled VAS improvement was 2.85 for low-dose and 3.06 for high-dose groups.
- No dose-response relationship was observed for functional outcomes (SMD 1.876).
Conclusions:
- Subacromial corticosteroid injections provide clinically meaningful pain relief and functional improvement regardless of dose.
- Findings suggest a potential therapeutic ceiling effect, with lower doses possibly achieving similar benefits.
- Further head-to-head trials are necessary to confirm dose equivalence and establish optimal dosing guidelines.
