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. 2025 Jan 1;38(1):29-42.
doi: 10.3344/kjp.24290. Epub 2024 Dec 23.

The impact of central sensitization-related symptoms on subacromial steroid injection outcomes in patients with subacromial impingement syndrome: an observational study

Feyza Nur Yücel  1 , Semiha Özgüç  1 , Yeliz Bahar-Özdemir  2 , Emre Ata  1
Affiliations

The impact of central sensitization-related symptoms on subacromial steroid injection outcomes in patients with subacromial impingement syndrome: an observational study

Feyza Nur Yücel et al. Korean J Pain. .

Abstract

Background: Evidence indicates that central sensitization (CS) plays a role in subacromial impingement syndrome (SIS). Reduced treatment response has been associated with pretreatment pain sensitization features, such as CSrelated symptoms.

Methods: Patients who received subacromial steroid injection were evaluated before the injection, at the first and third months. CS-related symptoms were investigated through the central sensitization inventory (CSI), and pain hypersensitivity was investigated by pressure pain threshold (PPT). Patients were evaluated using the visual analog scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand, Hospital Anxiety and Depression Scale, and Short Form-36.

Results: With the injection, all participants had a significant reduction in shoulder pain (P < 0.05). In all follow-ups, VAS values did not differ significantly between the groups, and patients with CSI ≥ 40 had higher levels of disability, anxiety, depression, and worse quality of life before treatment (P < 0.05). Post-injection disability decreased significantly in the CS group and reached similar levels in both groups at the third month (P > 0.05). Although both groups' PPT values were comparable pre-treatment and at the third month, the CS group's affected shoulder showed a notable PPT decline at the first month (P < 0.05).

Conclusions: Pre-treatment CS-related symptoms had no effect on SIS patients' responsiveness to steroid injections.

Keywords: Central Nervous System Sensitization; Chronic Pain; Pain Threshold; Rotator Cuff; Shoulder Impingement Syndrome; Shoulder Pain.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) diagram of participant flow through three months. CSI: central sensitization inventory, VAS: visual analog scale.
Fig. 2
Fig. 2
Locations of pressure pain threshold measurement points around the shoulder.
See this image and copyright information in PMC

References

    1. Horowitz EH, Aibinder WR. Shoulder impingement syndrome. Phys Med Rehabil Clin N Am. 2023;34:311–34. doi: 10.1016/j.pmr.2022.12.001. - DOI - PubMed
    1. Harrison AK, Flatow EL. Subacromial impingement syndrome. J Am Acad Orthop Surg. 2011;19:701–8. doi: 10.5435/00124635-201111000-00006. - DOI - PubMed
    1. Messina C, Banfi G, Orlandi D, Lacelli F, Serafini G, Mauri G, et al. Ultrasound-guided interventional procedures around the shoulder. Br J Radiol. 2016;89:20150372. doi: 10.1259/bjr.20150372. - DOI - PMC - PubMed
    1. Coronado RA, Simon CB, Valencia C, George SZ. Experimental pain responses support peripheral and central sensitization in patients with unilateral shoulder pain. Clin J Pain. 2014;30:143–51. doi: 10.1097/AJP.0b013e318287a2a4. - DOI - PMC - PubMed
    1. Paul TM, Soo Hoo J, Chae J, Wilson RD. Central hypersensitivity in patients with subacromial impingement syndrome. Arch Phys Med Rehabil. 2012;93:2206–9. doi: 10.1016/j.apmr.2012.06.026. - DOI - PMC - PubMed

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