From the Guidelines
Corticosteroid injections play a role in managing subacromial bursitis by providing short-term improvement in pain and function, particularly when pain is thought to be related to injury or inflammation of the subacromial region, such as the rotator cuff or bursa 1.
Key Points
- Subacromial corticosteroid injections can be used to treat pain related to inflammation of the subacromial region, including the rotator cuff or bursa 1.
- These injections can provide short-term improvement in pain and function, and can be used to supplement or facilitate exercise, physical therapy, and other conservative approaches 1.
- The evidence level for using subacromial corticosteroid injections for hemiplegic shoulder pain related to subacromial region injury or inflammation is B 1.
- It is essential to note that the evidence is insufficient to determine the extent to which repeated glucocorticoid injections increase potential risks, such as articular cartilage changes or sepsis 1.
Clinical Considerations
- Subacromial corticosteroid injections should be considered when other treatments, such as gentle stretching and mobilization techniques, and analgesics, have failed to provide adequate pain relief 1.
- The decision to use corticosteroid injections should be made on a case-by-case basis, taking into account the individual patient's condition and medical history 1.
From the Research
Role of Corticosteroid Injections
- Corticosteroid injections are used as a treatment method for subacromial bursitis (SB) or shoulder impingement syndrome (SIS) 2
- The steroid effect is relatively restricted to the short-term and repeated injections are frequently required, which contributes to unwanted side effects 2
- Ultrasound-guided subacromial corticosteroid injection can produce significantly greater improvements in passive shoulder abduction and in some items of the SF-36 compared to palpation-guided injection 3
Comparison with Other Treatments
- Corticosteroid injection was compared with botulinum toxin type B and showed significant improvement in Numeric Rating Scale (NRS), Disability of Arm, Shoulder, and Hand (DASH), and active shoulder abduction at 1 and 3 months follow-up 2
- Corticosteroid injection was compared with hyaluronic acid and normal saline injection, and showed that corticosteroid injection was effective and superior to hyaluronic acid and normal saline injection for treating chronic subacromial bursitis 4
- Combination of corticosteroid subdeltoid injections and physiotherapy was compared with either treatment alone, and showed that corticosteroid subdeltoid injection, or combined with physiotherapy, was superior to physiotherapy alone, but the recurrence rate was least in the physiotherapy group 5