Nonsteroidal anti-inflammatory drugs, corticosteroid, or other injections: a systematic review
Corticosteroid injection in the subacromial space
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The term subacromial impingement syndrome (SIS) encompasses a wide range of disorders, including rotator cuff syndrome, tendinopathy of the various rotator cuff tendons and bursitis in the shoulder region. The prescription of analgesics (often NSAIDs) and corticosteroid injections is common in primary care. This systematic review sought to determine and present an evidence-based overview of the effectiveness of pharmaceuticals in the treatment of SIS.
Interestingly, although their frequent application, there is no evidence for the effectiveness of corticosteroid injections or corticosteroid injections plus NSAIDs versus NSAIDs alone for SIS in the short term yet; even when compared to placebo interventions, no conclusive evidence is available on the effectiveness of both corticosteroid injections as well as corticosteroid injections plus NSAIDs.
More evidence is needed to determine the effectiveness of corticosteroid injections for treating SIS. This review has also highlighted a lack of evidence for the applications of simple analgesics (such as paracetamol), mild opioids (codeine phosphate) and other commonly prescribed NSAIDs in the treatment of SIS: oral ibuprofen seems to provide the most pain relief in the short term. > From: Van der Sande et al., Arch Phys Med Rehabil 94 (2013) 961-76. All rights reserved to the American Congress of Rehabilitation Medicine.