Physical Therapy Versus Steroid Injection for Shoulder Impingement Syndrome
Shoulder Impingement Syndrome
About this trial
This is an interventional treatment trial for Shoulder Impingement Syndrome focused on measuring Rotator cuff tendonitis, Shoulder pain, Shoulder impingement
Eligibility Criteria
Inclusion Criteria:
- Age between 18-65
- Read, write, and speak English
- Tricare beneficiary and eligible for healthcare at a military treatment facility
- Primary complaint of shoulder pain
- Meets diagnostic criteria for shoulder impingement (mentioned below)
To be included in the study participants are required to have:
- pain with one of the 2 tests in category I, and
- pain with one test from either category II or category III. * "pain" is defined as reproduction of the usual pain that the subject experiences that makes up the nature of their complaint.
Category I: Impingement signs
- Passive overpressure at full shoulder flexion with the scapula stabilized.
- Passive internal rotation at 90 degrees of shoulder flexion in the scapular plane and in progressive degrees of horizontal adduction.
Category II: Active shoulder abduction Active shoulder abduction Category Ill: resisted break tests
- Abduction
- Internal rotation
- External rotation
Exclusion Criteria:
- History of shoulder injection in last 3 months
- History of shoulder dislocation, subluxation, fracture, adhesive capsulitis of the glenohumeral joint, or cervical/shoulder/upper back surgery
- Full-thickness rotator cuff tears
- Presence of cervical radiculopathy, radiculitis, or referral from cervical spine
- Total baseline SPADI score not less than 20% (to prevent a ceiling effect with treatment)
- Prior OMPT treatment to the involved limb for the current episode of pain
- Military service members pending a medical evaluation board, a physical valuation board, or equivalent discharge process, or in medical hold to determine long term disposition. For non-military personnel, anyone that is pending or undergoing any litigation for their injury.
- Contraindication to receiving a corticosteroid injection (allergies, adverse reactions, history of multiple injections in that area even if not within last 30 days, etc)
- Inability to fill out informed consent form
- Unable to come into the clinic for regular treatment over the course of the following month.
Sites / Locations
- Madigan Army Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Manual Physical Therapy
Corticosteroid Injection (Subacromial)
The orthopaedic manual physical therapy (OMPT) intervention approach used in this study will be based on an impairment model. The physical therapist providing the intervention will address the impairments found in the shoulder joints to include the acromioclavicular joint, glenohumeral joint, and scapular-thoracic joints, and cervical/thoracic spine. Patients will receive procedures tailored to their specific impairments. Procedures will include mobilizations and manipulations of the joint and soft-tissues.
Location: Subacromial space; Syringe: 10mL; Needle: 25 gauge, 1.5 inch; Anesthetic: 6 mL of 1% lidocaine or marcaine; Corticosteroid: 1.0 mL Triamcinolone Acetonide (Kenalog), 40 mg/mL