Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis

Abstract

Background The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain.

Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review

“…Although our study differs in its primary objectives and methodology, our findings are similar to those reported in a recent review 23. The authors of this recent review did not identify any additional evidence that was not included in our review that may have influenced our findings.…”

Efficacy of hyaluronate injections in rotator cuff disorders: A meta-analysis

“…Currently, Mohamadi et al [11], performed a meta-analysis including eleven prospective randomized controlled trials comparing corticosteroid and placebo injections. The authors found that corticosteroid injections provide minimal transient pain relief in a small number of patients with rotator cuff tendinosis and cannot modify the natural course of the disease.…”

“…If the results of the conservative treatment fails, corticosteroid or anesthetics injection is often used in the management of persistent shoulder pain [11]. The potential mechanism of corticosteroids include decreased inflammation, inhibition of cellular proliferation, scarring and adhesion, and anti-nociceptive action [12].…”

“…The potential mechanism of corticosteroids include decreased inflammation, inhibition of cellular proliferation, scarring and adhesion, and anti-nociceptive action [12]. However, their effectiveness is ascertained only in the short term follow-up and occurrence of local degradation of tissues has been reported as a result of repeated corticosteroid injection, as well as tendon tearing and corticosteroid arthropathy [11]. Therefore, their use should be restricted to selected cases.…”

A comparison of the effectiveness of lateral versus posterior approach to shoulder injection in patients with subacromial impingement syndrome: A pragmatic randomized controlled trial

“…These authors concluded that cortisone injection was well tolerated, with rare and minor side effects, such as transient post-injection pain and skin modification. Similarly, Mohamadi, Chan, Claessen, Ring, and Chen (2016), in a recent systematic review and meta-analysis of 11 RCTs, found that cortisone injections provided moderate pain relief for patients with rotator cuff disorders up to 2 months after the injection, but the effect was not sustained after 3 months. However, two systematic reviews (Koester, Dunn, Kuhn, & Spindler, 2007;van der Heijden, van der Windt, Kleijnen, Koes, & Bouter, 1996) reported that the evidence establishing the efficacy of subacromial cortisone injection in shoulder pathologies is equivocal.…”