Comparative effect of triamcinolone/lidocaine ultrasonophoresis and injection on pain, disability, quality of life in patients with acute rotator cuff related shoulder pain: a double blinded randomized controlled trial

Abstract

ABSTRACT Background Alleviatinginflammation should be considered as one of the first steps of the treatmentplan in patients with acute rotator cuff related shoulder pain (RCRSP). Objective To compare theeffects of triamcinolone/lidocaine ultrasonophoresis, injection on pain,disability, and quality of life in patients with acute RCRSP. Methods A total of 28 acuteRCRSP patients were randomly allocated into two groups of ultrasonophoresis andinjection. Both groups received vitamin C and shoulder care education for 10 days and then were subjected to therapeutic interventions.Ultrasonophoresis group received triamcinolone (16 mg) and lidocaine (2mg) usingultrasonophoresis (frequency: 3 MHz, intensity: 1.50 W/Cm2), while the injectiongroup received a single subacromial injection of triamcinolone (80 mg) and lidocaine(10 mg). The main outcomes measures were pain assessed by two scales (visualanalog scale), and shoulder pain and disability index (SPADI), disability (SPADI),and quality of life (Western Ontario rotator cuff questionnaire). Results Although themain effect of time was statistically significant for all dependent variables(P< 0.01), no significant interaction was found between group and time (P-value(0.12-0.55)). The ultrasonophoresis effect, size for pain, disability, andquality of life were 2.58, 1.43, 1.78, and 1.35, respectively. The injectioneffect, size for pain, disability, and quality of life were 1.98, 2.02, 1.40,and 1.60, respectively. Conclusions Triamcinolone/lidocaineultrasonophoresis demonstrated similar outcomes to injection in reducing pain,improving disability, and enhancing quality of life in patients with acuteRCRSP in short time. According to our findings, ultrasonophoresis withtriamcinolone/lidocaine cream is as effective as triamcinolone/lidocaineinjection and can be proposed as a potential adjunctive treatment for patientswith acute RCRSP.