Year 2018, Volume 18, Issue 4, Pages 683 - 689 2018-12-27

Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği
Efficacy of Corticosteroid Injection in the Conservative Treatment of Subacromial Impingement Syndrome

Safa Gürsoy [1]

39 295

Amaç: Çalışmamızın amacı omuz subakromial sıkışma sendromunun (SSS) tedavisinde tek başına fizik

tedavi ile fizik tedavi ile kombine subakromial kortikosteroid enjeksiyonu uygulamasının etkinliğinin

karşılaştırılmasıdır.

Materyal ve Metot: 30‐65 yaş arası, rotator kılıf yırtığı olmayan 56 SSS tanısı alan hasta çalışmaya dahil

edildi. Yalnızca fizik tedavi alan hastaların oluşturduğu Grup 1(n=26) ile fizik tedavi ile birlikte

subakromial kortikosteroid enjeksiyonu yapılan hastaların oluşturduğu Grup 2(n=30), işlem öncesi

döneme kıyasla 3., 6. ve 12. ayda ölçülen Visual Analog Scale (VAS) ve American Shoulder and Elbow

Surgeons (ASES) skorlamaları kullanılarak karşılaştırıldı.

Bulgular: Her iki grup arasında anlamlı farklılık 3. ve 6. ay VAS ve ASES skorlarında Grup 2(fizik tedavi

ile birlikte enjeksiyon uygulaması) lehine bulunmuştur (p<0,001) 12. ay takiplerinde VAS(p=0,539) ve

ASES(p=0,117) ölçümlerindeki değişim, gruplar açısından istatistiksel olarak anlamlı değildir. Her iki

grupta da işlem öncesi döneme göre 3. ve 6. ay takiplerinde istatistik olarak anlamlı bir artış

saptanmıştır.

Sonuç: Kortikosteroid enjeksiyonu ile birlikte fizik tedavi uygulaması sadece fizik tedavi uygulaması ile

kıyaslandığında kısa dönemde daha etkili olduğu ancak her iki yöntemin de ağrıyı azalttığı ve

fonksiyonlarda iyileşme sağladığı düşünülmektedir.

Objectives: The aim of our study was to compare the efficacy of physical therapy and the combination of physical therapy and subacromial corticosteroid injection in the treatment of shoulder subacromial impingement syndrome (SIS).

Materials and Methods: 56 patients aged between 30-65, who did not have a rotator cuff tear and were diagnosed with SIS, were enrolled in this study. Group 1 (n=26) constituted by patients who were only receiving physical therapy and Group 2 (n=30) constituted by patients who were receiving the combination of physical therapy and subacromial corticosteroid injection were compared using Visual Analogue Scale (VAS) and American Shoulder and Elbow Surgeons (ASES) scores at post-treatments months 3, 6 and 12 in comparison to the pre-treatment period.

Results: There was a statistically significant difference between the two groups in favor of Group 2 (combination of physical therapy and injection) in terms of VAS and ASES scores at months 3 and 6 (p<0.001). The change in VAS (p=0.539) and ASES (p=0.117) measurements of the groups at month 12 was not statistically significant. There was a statistically significant increase in both groups throughout the 3rd and 6th months follow-up period as compared to the pre-treatment period.

Conclusion: It is thought that the combination of corticosteroid injection and physical therapy is more effective in the short-term as compared to physical therapy only, however both methods alleviate pain and provide improvement in functions.  

  • 1. Chard M, Hazleman R, Hazleman BL, King RH, Reiss BB. Shoulder disorders in the elderly: a community survey. Arthritis Rheum 1991;34:766–9.
  • 2. Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003;102:167–78.
  • 3. van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: incidence, patient characteristics and management. Ann Rheum Dis 1995;54:959–64.
  • 4. Neer CS. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972;54(1):41–50.
  • 5. Hanchard NC1, Goodchild L, Thompson J, O'Brien T, Davison D, Richardson C. Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary. Physiotherapy. 2012;98(2):117-20.
  • 6. Neer CS. Impingement lesions. Clin Orthop Relat Res 1983;173:70–7.
  • 7. Neer CS, Welsh RP. The shoulder in sports. Orthop Clin North Am 1977;8: 583–91.
  • 8. Hawkins RJ, Kennedy JC. Impingement syndrome in athletes. Am J Sports Med 1980;8:151–8.
  • 9. Dorrestijn O, Stevens M, Winters JC, van der Meer K, Diercks RL. Conservative or surgical treatment for subacromial impingement syndrome? A systematic review. J Shoulder Elbow Surg 2009;18(4):652–60.
  • 10. Gebremariam L, Hay EM, Koes BW, Huisstede BM. Effectiveness of surgical and postsurgical interventions for the subacromial impingement syndrome: a systematic review. Arch Phys Med Rehabil 2011;92(11):1900–13.
  • 11. Kibler WB, McMullen J, Uhl T. Shoulder rehabilitation strategies, guidelines and practice. Orthop Clin N Am 2001;32:527–38.
  • 12. Engebretsen K, Grotle M, Bautz-Holter E, Sandvik J, Juel NG, Ekeberg OM, Brox JL. Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study. BMJ 2009;339:b3360.
  • 13. Crawshaw DP, Helliwell PS, Hensor EM, Hay EM, Aldous SJ, Conaghan PG. Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial. BMJ 2010;340:c3037.
  • 14. Holmgren T, Bjornsson Hellgren H, Oberg B, Adolfsson L, Johansson K. Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. BMJ 2012;344:e787.
  • 15. Ottenheijm RP, Jansen MJ, Staal JB, van den Bruel A, Weijers RE, de Bie RA. Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2010;91(10):1616–25.
  • 16. Chen MJ, Lew HL, Hsu TC, Tsai WC, Lin WC, Tang SF. Ultrasoundguided shoulder injections in the treatment of subacromial bursitis. Am J Phys Med Rehabil. 2006;85(1):31–5.
  • 17. Diercks R, Bron C, Dorrestijn O, Meskers C, Naber R, de Ruiter T. Guideline for diagnosis and treatment of subacromial pain syndrome. Acta Orthop. 2014;85(3):314–22.
  • 18. Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Semin Arthritis Rheum. 2012;42(3):297–316.
  • 19. Koester MC, Dunn WR, Kuhn JE, Spindler KP. The efficacy of subacromial corticosteroid injection in the treatment of rotator cuff disease: A systematic review. J Am Acad Orthop Surg. 2007;15(1):3–11.
  • 20. Toigo M, Boutellier U. New fundamental resistance exercise determinants of molecular and cellular muscle adaptations. Eur J Appl Physiol. 2006;97(6):643–63.
  • 21. Cole BF, Peters KS, Hackett L, Murrell GA.Ultrasound-Guided Versus Blind Subacromial Corticosteroid Injections for Subacromial Impingement Syndrome: A Randomized, Double-Blind Clinical Trial. Am J Sports Med. 2016;44(3):702-7.
  • 22. Bennell K, Wee E, Coburn S, Green S, Harris A, Staples M. Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial. BMJ 2010;340:c2756.
  • 23. Johansson K, Bergström A, Schröder K, Foldevi M. Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care--a randomized clinical trial. Fam Pract 2011;28(4):355-65.
Primary Language tr
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Author: Safa Gürsoy (Primary Author)

Dates

Publication Date: December 27, 2018

Bibtex @research article { amj501834, journal = {Ankara Medical Journal}, issn = {}, eissn = {2148-4570}, address = {Ankara Yildirim Beyazit University}, year = {2018}, volume = {18}, pages = {683 - 689}, doi = {10.17098/amj.501834}, title = {Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği}, key = {cite}, author = {Gürsoy, Safa} }
APA Gürsoy, S . (2018). Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği. Ankara Medical Journal, 18 (4), 683-689. DOI: 10.17098/amj.501834
MLA Gürsoy, S . "Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği". Ankara Medical Journal 18 (2018): 683-689 <http://www.ankaramedicaljournal.com/issue/40944/501834>
Chicago Gürsoy, S . "Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği". Ankara Medical Journal 18 (2018): 683-689
RIS TY - JOUR T1 - Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği AU - Safa Gürsoy Y1 - 2018 PY - 2018 N1 - doi: 10.17098/amj.501834 DO - 10.17098/amj.501834 T2 - Ankara Medical Journal JF - Journal JO - JOR SP - 683 EP - 689 VL - 18 IS - 4 SN - -2148-4570 M3 - doi: 10.17098/amj.501834 UR - https://doi.org/10.17098/amj.501834 Y2 - 2019 ER -
EndNote %0 Ankara Medical Journal Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği %A Safa Gürsoy %T Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği %D 2018 %J Ankara Medical Journal %P -2148-4570 %V 18 %N 4 %R doi: 10.17098/amj.501834 %U 10.17098/amj.501834
ISNAD Gürsoy, Safa . "Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği". Ankara Medical Journal 18 / 4 (December 2018): 683-689. https://doi.org/10.17098/amj.501834
AMA Gürsoy S . Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği. Ankara Med J. 2018; 18(4): 683-689.
Vancouver Gürsoy S . Kortikosteroid Enjeksiyonunun Subakromiyal Sıkışma Sendromunun Konservatif Tedavisinde Etkinliği. Ankara Medical Journal. 2018; 18(4): 689-683.