The effectiveness of comprehensive physiotherapy compared with corticosteroid injection on pain, disability, treatment effectiveness, and quality of life in patients with subacromial pain syndrome: a parallel, single-blind, randomized controlled trial

ABSTRACT

Objective

Comparing short- and long-term effects of comprehensive physiotherapy (CP) and subacromial corticosteroid injection (SCI) on pain, disability, and quality of life in the patients with subacromial pain syndrome (SAPS).

Design

2 × 4 randomized controlled trial.

Participants

50 participants with unilateral SAPS.

Intervention

Random assignment with allocation concealment into two groups labeled as 12 sessions, supervised CP (n = 22) and 1cc triamhexal SCI (n = 25).

Outcomes

Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), and Western Ontario Rotator Cuff Index (WORC). Outcomes were gathered pre- and post-intervention, with three- and six-month follow-ups.

Results

Variance analysis revealed that there was a significant interaction of group-in-time for SPADI and WORC (P < .05) but not for Quick-DASH and VAS (P > .05). The independent t-test analysis showed that the mean scores of all outcome measures in CP group were lesser than SCI group via 6 months (P < .05), except for the VAS (P > .05, mean difference = −0.97, 95% confidence interval −2.11–0.15).

Conclusion

CP results in statistically significant and potentially clinically important difference in function and quality of the life at all timeframe. Moreover, there was no between group difference in order to reduce pain.

KEYWORDS:

• Subacromial pain syndrome
• physiotherapy
• corticosteroid injection
• pain
• disability
• quality of life

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Acknowledgments

The authors wish to thank the GPs and physiotherapists who worked in Ghaem Hospital for the collaboration and the patients who participated to make this study possible. The authors thanks to Mashhad University of Medical Sciences for the financial support (GRANT NUMBER: 961260).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Mashhad University of Medical Sciences have funded the project (GRANT NUMBER: 961260).