Traditional Treatments Underfire - Steroid Injections and Shoulder Pain

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 the results of traditional shoulder pain treatment in the primary care setting and the effects of those treatments. Both studies attempted 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.

Dr. Van Der Windt's study in the Netherlands found that the effectiveness of a steroid injection did help in the short term, but not as much in the long term. The study did not find any difference in the status of a sufferer of shoulder pain when their situation was reassessed twelve months later when their treatment consisted of physical therapy and steroid injections into the shoulder.

Dr. Hay's study found similar results in the United Kingdom, where it was noted that the success of steroid injections were evident in the short term, but the treatment became less helpful in the longer term. These groups did not necessarily differentiate the exact cause of the shoulder pain, but focused more on treatment. Overall, both researchers found that patients realized similar improvement even though the United Kingdom group was given steroid injections later in the course of the treatment.

In their conclusions, they note that further study needs to be considered before a wider assessment of the place of steroid injections within the treatment options for shoulder injuries can take place. However, it seems important that doctors reassess their traditional treatment options, and the role that steroid injections have in that plan, since they have been found to lack long term benefit. And while the authors call into question the role of steroid injections in shoulder pain treatment, they hold that physical therapy is still an integral and effective part of treatment. Both studies found that their study groups had almost 90% improvement in their respected populations and they feel that supports more aggressive use of physical therapy for shoulder pain.

Michael Carroll, MD is a board certified family physician with a special interest in sports medicine. He is the founding partner of Creekside Clinic, LLC, a progressive primary care center in Traverse City, Michigan. He is also a member of the American College of Sports Medicine, and the American Academy of Family Physicians.

Dr. Carroll is also interested in shoulder pain treatment and rotator cuff injuries and has designed a ground-breaking new treatment tool that has seen amazing results in studies at the American College of Sports Medicine.