Extracorporeal Shock Wave Therapy vs. Corticosteroid Local Injection in Shoulder Impingement Syndrome A Three-Arm Randomized Controlled Trial

ObjectiveThe aim of this study was to examine the effects of combining extracorporeal shock wave therapy or local corticosteroid injections with a conventional physical therapy (CPT) program for patients with shoulder impingement syndrome.DesignThis was a prospective single-blinded, randomized controlled study.MethodsSixty patients with unilateral shoulder impingement syndrome >3 mos were allocated to group A (a 4-wk program of CPT plus a single local corticosteroid injection of 40 mg triamcinolone acetonide mixed with 1% xylocaine, n = 20), group B (CPT only, n = 20), and group C (CPT plus extracorporeal shock wave therapy, 2000 impulses, 0.2-0.3 mJ/mm(2), one session per week for 3 wks, n = 20). Subacromial space, shoulder pain and disability index, and shoulder range of motion were assessed at baseline and 4 and 12 wks posttreatment.ResultsThere were no between-group differences at 4 wks. At the 12-wk follow-up, no significant differences were found between groups A and B. There was a significant difference in favor of group C compared with group A with the expectation of shoulder internal rotation and subacromial space. Group C was also superior to group B in all outcomes except for subacromial space.ConclusionThe addition of extracorporeal shock wave therapy to CPT induced more noticeable intermediate-term effects than CPT plus local corticosteroid injection or CPT alone.

Automated summary

This study aimed to investigate the effects of combining extracorporeal shock wave therapy or local corticosteroid injections with conventional physical therapy (CPT) for patients with shoulder impingement syndrome. Sixty patients were allocated to three groups and assessed for subacromial space, shoulder pain and disability index, and shoulder range of motion. The results showed that the addition of extracorporeal shock wave therapy to CPT had more noticeable intermediate-term effects compared to CPT plus local corticosteroid injection or CPT alone.