Comparing the effect of physiotherapy and physiotherapy plus corticosteroid injection on pain intensity, disability, quality of life, and treatment effectiveness in patients with Subacromial Pain Syndrome: a randomized controlled trial

Manual Therapy and Exercise Have Similar Outcomes to Corticosteroid Injections in the Management of Patients With Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis

“…Three of the included studies used a multimodal physiotherapy treatment including electrotherapy, ultrasound, ice, or hot packs in addition to the EMT programme [ 28 , 29 , 32 ]. Five of the eligible studies provided a home exercise programme (HEP) for patients following the EMT approach [ 7 , 9 , 11 , 27 , 32 ]. However, only two studies used a HEP in addition to the corticosteroid injection intervention [ 11 , 31 ].…”

“…Two trials performed a direct comparison between EMT combined with corticosteroid injections and EMT alone [ 11 , 27 ]. The mean age of the participants analysed (n = 92) was 51.5 years.…”

“…The substantial inconsistency observed in the quantitative synthesis may also be attributed to the patient characteristics that were included among the eligible studies. For example, most trials either did not report critical demographic characteristics of participants (such as type or duration of symptoms) [ 27 , 28 , 31 ], or their sample varied greatly in terms of chronicity [ 11 , 29 ]. Evidence suggests that symptom duration and severity of pain are critical prognostic indicators for treatment success in patients with shoulder pain [ 31 , 38 ].…”

“…Screening titles and abstracts left 43 records for full-text evaluation, of which 35 studies did not meet the eligibility criteria. Eight RCTs were finally included [6,11,[27][28][29][30][31][32]. The search results are shown in Figure 1.…”

“…Conservative approaches are considered first-line treatments, presenting similar results to surgical interventions [ 2 , 9 ]. The most commonly used nonsurgical interventions include a multimodal physiotherapy programme with exercise and manual therapy (EMT) or corticosteroid injections [ 10 , 11 ]. Several studies have shown that EMT can significantly improve pain and function in patients with SAPS [ 2 , 12 , 13 ]; however, the extent of their effectiveness remains unclear [ 2 , 8 , 13 ].…”