Efficiency of local hyaluronic acid injections in subacromial impingement syndrome

Abstract

Chronic shoulder pain associated with subacromial impingement syndrome (SIS) is a common pathology that causes suffering and disability. One of the treatments for SIS is the local injection of hyaluronic acid (HA) preparations.Objective:to evaluate the efficiency of subacromial injection of HA in chronic shoulder pain associated with SIS.Subjects and methods.A study group consisted of 31 patients (48.4% of women and 51.6% of men; mean age 53.8±15.2 years) with chronic shoulder pain (>3 months) that had occurred after rotator tendon injury confirmed by ultrasound and/or magnetic resonance imaging. All the patients received two subacromial injections of 40 mg HA in 2 ml at a 7-day interval. The efficacy criteria were the changes of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at 1, 3 and 6 months.Results and discussion.During the treatment, there was a considerable improvement in all measures. At baseline and 1, 3, and 6 months, the mean pain severity measured on VAS was 60.0±20.0, 40.0±25.4, 31.6±26.0, and 32.2±26.5 mm (p<0.001), the mean ASES scores were 53.64±16.43, 70.08±17.70, 86.13±12.86, and 82.69±27.88 (p<0.001); the mean CSC scores were 52.38±21.1, 66.26±20.83, 73.9±24.14, and 76.1±25.02 (p<0.001) respectively. No serious adverse events were noted.Conclusion.Subacromial injection of HA is an effective and safe treatment for chronic shoulder pain associated with SIS.

Comparison of the efficacy of physiotherapy, subacromial corticosteroid, and subacromial hyaluronic acid injection in the treatment of subacromial impingement syndrome: A retrospective study

“…The effectiveness of subacromial corticosteroid injection for pain relief in patients with SIS has been reported in a number of studies 10–12. Subacromial injection of hyaluronic acid, as a nonsteroidal agent with antiinflammatory properties, also has been shown to be effective in lessening pain and improving function in patients with SIS 13,14…”

“…[10][11][12] Subacromial injection of hyaluronic acid, as a nonsteroidal agent with antiinflammatory properties, also has been shown to be effective in lessening pain and improving function in patients with SIS. 13,14 Some studies have evaluated the efficacy of subacromial corticosteroid versus hyaluronic acid injection for symptom management in patients with SIS. [15][16][17][18] However, because of variations in methodological quality and outcome measures, the superiority of either injections or their effectiveness in comparison with the standard choice of treatment (physiotherapy) is not clear.…”