Abstract
Objective: To evaluate the effects of subacromial bursa injection in subacromial impingement with hyaluronic acid and compare its outcome results with the corticosteroid. Method: A total of 88 patients with subacromial impingement were randomised to treatment with subacromial bursa injection, 44 patients underwent subacromial bursa injection with hyaluronic acid (Group A) and other 44 patients (Group B) treated with steroid. Patients were followed up for 24 weeks. Primary outcome was pain on Visual analogue scale (VAS)and secondary outcome measured was Constant Murley score. Result: Both the groups showed statistically significant improvement in VAS, Constant Murley score and shoulder movement range at 3rd week after the injection. However when comparing the extant of improvement of outcome measures at 24 weeks to the baseline in both groups, it was statistically not significant (P>0.05). Conclusion: The different outcome measures in both hyaluronic acid and steroid injections groups showed similar results, however steroids produces faster pain relieve compared to the hyaluronic acid Keywords: Shoulder impingement syndrome, Subacromial bursa injection, hyaluronic acid, steroid
Highlights
Shoulder pain is very common, it is second most frequent musculoskeletal disorder[1] and shoulder impingement is the leading cause of pain.[2]
When pain relief is insufficient, a subacromial bursa injection of steroid advised for pain control and improvement of shoulder functions.[3,4,5,6,7,8,9]
Group A patients injected with 2ml lidocain 1% and 2ml Hyaluronic acid combination
Summary
Shoulder pain is very common, it is second most frequent musculoskeletal disorder[1] and shoulder impingement is the leading cause of pain.[2]. When pain relief is insufficient, a subacromial bursa injection of steroid advised for pain control and improvement of shoulder functions.[3,4,5,6,7,8,9]. Some guidelines advocate physiotherapy or manipulative therapy.[10] Crawshaw et al[6] reported that physiotherapy combined with sub-acromial injection give better results than each separately. A few studies have demonstrated improvement in shoulder pain and functions following the injection of hyaluronic acid alone in sub-acromial bursa.[11,12,13,14] The hyaluronic acid is though to work as lubricant[15] and is reported to have an anti-inflammatory effects.[16]
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