Effect of Combined Ultrasound-guided Subdeltoid Corticosteroid Injections and Physiotherapy in Treatment of Patients With Chronic Subacromial Bursitis
Subacromial Bursitis, Subacromial Impingement Syndrome, Physical Therapy
About this trial
This is an interventional treatment trial for Subacromial Bursitis focused on measuring subacromial bursitis, subacromial impingement syndrome, corticosteroid, physical therapy, therapeutic exercise, rehabilitation
Eligibility Criteria
Inclusion Criteria:
- shoulder pain for more than 1 month
- age ≥20 years old
- painful abduction or internal rotation with a visual analog scale (VAS) pain score ≥4
- the presence of a painful arc of motion or pain at the middle to terminal range of shoulder abduction or internal rotation with an empty or soft end feel
- positive shoulder impingement test (Neer test and/or Hawkin test)
- a reduction in pain of ≥40% on active shoulder abduction or internal rotation at the terminal range after injection of 3ml of 1%lidocain into the SASD bursa under US guidance.
Exclusion Criteria:
- a history of uncontrolled chronic diseases, e.g., malignant neoplasms, blood dyscrasia, and serious infection
- previous surgery of the affected shoulder
- any evidence of a rotator cuff tear or tendinopathy, demonstrated by positive resistive tests andsonographic findings
- calcification of the rotator cuff, demonstrated by x-ray or sonographic findings
- the presence of arthritis, such asinflammatory arthritis(e.g., rheumatoid arthritis, seronegativespondyloarthropathy, or crystal-related arthropathy), osteoarthritis, frozen shoulder, subacromial spurs, or deformity of the acromion
- the presence of instability of the affected shoulder
- a previous fracture near the shoulder region
- the presence of cervical radiculopathy or myelopathy
- having received a corticosteroid or hyaluronic acid subacromial or shoulder joint injection in the past 3 months.
Sites / Locations
- Shin Kong Wu Ho-Su Memorial Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Triamcinolone SASD injection
Physiotherapy
Triamcinolone injections & Physiotherapy
2ml triamcinolone (1ml/10mg) and 3ml 1% xylocain will be injected into the affected SASD bursa under ultrasound guidance.
The physiotherapy program consists of hot pack, interferential therapy, and exercise program, which includes stretch exercise, mobilization of the glenohumeral joint, manual pressure to the possible trigger points, scapular stabilization exercise, and strengthening exercise of the rotator cuff, trapezius, and serratus anterior muscles.
2ml triamcinolone (1ml/10mg) and 3ml 1% xylocain will be injected into the affected SASD bursa under ultrasound guidance. The physiotherapy program consists of hot pack, interferential therapy, and exercise program, which includes stretch exercise, mobilization of the glenohumeral joint, manual pressure to the possible trigger points, scapular stabilization exercise, and strengthening exercise of the rotator cuff, trapezius, and serratus anterior muscles.