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Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review.

Cook, Tim and Minns Lowe, Catherine and Maybury, Mark and Lewis, Jeremy S (2018) Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review. British journal of sports medicine. ISSN 1473-0480. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Abstract

OBJECTIVE

To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP).

DESIGN

Systematic review with best evidence synthesis.

DATA SOURCES

The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Reference lists of included articles were also hand searched.

ELIGIBILITY CRITERIA

Two reviewers independently evaluated eligibility. Randomised controlled trials (RCTs) were included if they compared subacromial injections of corticosteroid with anaesthetic injections. Two reviewers independently extracted data regarding short-term, midterm and long-term outcomes for pain, self-reported function, range of motion and patient-perceived improvement.

RESULTS

Thirteen RCTs (n=1013) were included. Four trials (n=475) were judged as being at low risk of bias. Three studies of low risk of bias favoured the use of corticosteroid over anaesthetic-only injections in the short term (up to 8 weeks). There was strong evidence of no significant difference between injection types in midterm outcomes (12-26 weeks). There was limited evidence of no significant difference between injection types in long-term outcomes.

CONCLUSION

Corticosteroid injections may have a short-term benefit (up to 8 weeks) over local anaesthetic injections alone in the management of RCRSP. Beyond 8 weeks, there was no evidence to suggest a benefit of corticosteroid over local anaesthetic injections.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42016033161.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: WE Musculoskeletal. Orthopaedics
Divisions: Emergency Services > Therapies
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 07 Feb 2018 11:22
Last Modified: 07 Feb 2018 11:22
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1588

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