Corticosteroid Injection Versus Tendon Dry Needling for Subacromial Impingement Syndrome

Inclusion Criteria: Adult patients aged 18-65 years old Diagnosis of subacromial impingement syndrome, confirmed by clinical examination and imaging (such as X-ray or MRI) Moderate to severe shoulder pain, with a score of at least 4 on a 0-10 visual analog scale (VAS) for pain Willingness to comply with the study protocol and attend all study visits and assessments Ability to provide informed consent to participate in the study. Exclusion Criteria: Contraindications to corticosteroid injection or dry needling, such as local infection, bleeding disorders, or allergy to the injectate or needle Previous shoulder surgery on the affected shoulder Other active shoulder conditions, such as rotator cuff tear or adhesive capsulitis, that may confound the study results Systemic conditions, such as rheumatoid arthritis or osteoarthritis, that may affect the shoulder joint and its function History of shoulder dislocation or instability Pregnancy or breastfeeding Current use of systemic corticosteroids or immunosuppressive drugs Injection to shoulder area in the past six months. Inability to complete the study assessments or follow the study protocol, such as due to cognitive impairment or language barrier.