مرکز منطقه ای اطلاع رساني علوم و فناوري - The contribution of subacromial injection to the conservative treatment of impingement syndrome

Latin Abstract :

Objectives: We evaluated the contribution of subacromial lo¬cal anesthetic and corticosteroid injection to the conservative treatment of subacromial impingement syndrome. Methods: The study included 56 patients (39 women, 17 men; mean age 50 years; range 31 to 68 years) with subacromial im¬pingement syndrome without any rotator cuff lesion. The patients were randomly allocated to injection and control groups equal in number. The former group received a single subacromial injec¬tion of 9 ml bupivacaine and 1 ml betamethasone at the begin¬ning of the treatment. The same physical therapy and rehabilita¬tion program was administered to both groups, consisting of 15 sessions (3 weeks). Evaluations were made before, and three and six weeks after treatment. Functional results were assessed us¬ing the Constant score, pain was assessed using a visual analog scale, and range of motion was measured with a goniometer. Results: Compared to pretreatment values, both groups exhib¬ited significant improvements in pain score, Constant score, and range of motion measurements at three and six weeks (p<0.05). Pain score decreased by 37.7% in the injection group after 24 hours of injection. Pretreatment Constant scores which were 39.9±13.9 and 40.3±13.4 in the injection and control groups in¬creased to 68.4±7.6 and 64.7±7.7 at six weeks, respectively. No significant differences were seen in pain scores between the two groups at three and six weeks (p>0.05). Patients receiving sub¬acromial injection had significantly higher Constant scores at six weeks (p=0.044) and significantly greater external and internal rotation at three weeks (p=0.03). Range of motion measurements did not differ between the two groups at six weeks (p>0.05). Conclusion: Subacromial injection contributes to the suc¬cess of the conservative treatment through decreasing pain and enabling more effective range of motion and strengthen¬ing exercises, both of which are associated with increased functional improvement.