Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2005 Mar;55(512):224-8.

Corticosteroid injections for painful shoulder: a meta-analysis

Bruce Arroll  1 , Felicity Goodyear-Smith
Affiliations
Meta-Analysis

Corticosteroid injections for painful shoulder: a meta-analysis

Bruce Arroll et al. Br J Gen Pract. 2005 Mar.

Abstract

Background: There are no systematic reviews of corticosteroids for shoulder pain that calculate the numbers needed to treat.

Aim: We wished to determine the effectiveness in terms of improvement of symptoms of intra-articular and subacromial injections of corticosteroid for rotator cuff tendonitis and frozen shoulder.

Design of study: Systematic review and meta-analysis of randomised controlled trials.

Method: Data sources included the Cochrane Controlled Trials Register, Medline, EMBASE, hand searches and author contacts. The review methods required any randomised controlled trial in which the effectiveness of subacromial or intra-articular steroid injections versus placebo and versus non-steroidal anti-inflammatory medication, could be ascertained. The outcome was improvement of symptoms. The data abstraction was done independently, as was the validity assessment. The data was pooled using Review Manager 4.1.

Results: Seven studies were reviewed for corticosteroids versus placebo and three for corticosteroids versus nonsteroidal anti-inflammatory drugs (NSAIDs). The relative risk for improvement for subacromial corticosteroid injection for rotator cuff tendonitis was 3.08 (95% confidence interval [CI] = 1.94 to 4.87). The number needed to treat based on the pooled relative risk was 3.3 (95% CI = 1.8 to 7.7) patients to obtain one improvement. The relative risk for high dose (50 mg of prednisone or more) was 5.9 (95% CI = 2.8 to 12.6). The relative risk for improvement with steroids compared with NSAIDs was 1.43 (95% CI = 0.95 to 2.16). The number needed to treat for corticosteroids versus NSAIDs was 2.5 (95% CI = 1 to 9) for one significant study. The relative risks for intra-articular steroid injection for rotator cuff tendonitis were not statistically significant.

Conclusion: Subacromial injections of corticosteroids are effective for improvement for rotator cuff tendonitis up to a 9-month period. They are also probably more effective than NSAID medication. Higher doses may be better than lower doses for subacromial corticosteroid injection for rotator cuff tendonitis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Process of inclusion of studies and usable information.
See this image and copyright information in PMC

Comment in

References

    1. Badcock LJ, Lewis M, Hay EM, et al. Chronic shoulder pain in the community: a syndrome of disability or distress? Ann Rheum Dis. 2002;61:128–131. - PMC - PubMed
    1. Palmer KT, Cooper C, Walker-Bone K, et al. Use of keyboards and symptoms in the neck and arm: evidence from a national survey. Occup Med (Lond) 2001;5:392–395. - PubMed
    1. Green S, Buchbinder R, Glazier R, Forbes A. Interventions for shoulder pain: systematic review. Cochrane Musculoskeletal Group Cochrane Database of Systematic Reviews. 2002:3. - PubMed
    1. McQuay HJ, Moore RA, Eccleston C, et al. Systematic review of outpatient services for chronic pain control. Health Technol Assess. 1997;1:i–iv. 1–135. - PubMed
    1. Van der Heijden GJ, van der Windt DA, Kleijnen J, et al. Steroid injections for shoulder disorders: a systematic review of randomised clinical trials. Br J Gen Pract. 1996;46:309, 316. - PMC - PubMed

MeSH terms

Substances