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July 18, 2007

Treatment of Shoulder Pain: What Works

In a recent study from the Annals of Rheumatic Diseases, the authors, Dr. Hay and Dr. Van Der Windt, out of both the Netherlands and United Kingdom, compared how people did when they had their shoulder pain treated in the primary care setting.  They tried to assess the differences in how these patients were treated and the progress they made.  They first noted that shoulder problems are common with up to 47% adults in the general population reporting such symptoms in a 1 year period. 

In the Netherlands trial, performed by Dr. Van Der Windt, it was found that the effectiveness of a steroid injection did help in the short term, but did not show any evidence there is a long term difference in the recovery when compared at 12 months.  These people were also referred to physical therapy. 

In the United Kingdom group, a study performed by Dr. Hay, it was also noted that the success of steroid injection was also helpful in the short term, but not in the long term.  These groups did not necessarily differentiate the exact cause of the shoulder pain, but focused more on treatment.  Overall they found there was similar improvement between the two groups despite the United Kingdom group using steroid injections later on in the course of the treatment. 

In their conclusions, they note that further study needs to be considered for the place of steroid injections given that they have not been shown to have long term benefit.  The authors are also proponents of continued physical therapy for this and know that in their study groups they had almost 90% improvement in their respected populations and they feel that supports more aggressive use of physical therapy for shoulder pain.


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But steroids could cause other health problems, am I right?

Not really just a shot or two. They do not have the systemic side effects that you hear all about with steroids.

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