In a study scheduled for publication in the December issue of the Archives of Physical Medicine and Rehabilitation, researchers report on the first comparative study of the two most commonly corticosteroid doses administered for shoulder pain. They found that lower doses were just as effective as higher doses in terms of reduction of pain, improved range of motion and duration of efficacy.
"There has been no guidance for adequate corticosteroid doses during subacromial injection. Physicians have depended mainly on their experience for the selection of dose", commented lead investigator Seung-Hyun Yoon, MD, PhD, Assistant Professor, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea. "This is the first study to assess the efficacy of corticosteroid according to two different doses, which are the most widely used in subacromial injection for participants with periarticular shoulder disorders. Initial use of a low dose is encouraged because there was no difference in efficacy according to dose, and the effect of corticosteroid lasted up to 8 weeks."
Investigators conducted a randomized, triple-blind, placebo-controlled clinical trial in which 79 patients with at least one month's duration of pain were enrolled. Subjects were randomly assigned to three groups with 27 participants receiving a 40 mg dose of triamcinolone acetonide; 25 a 20 mg dose and 27 a placebo injection. All were followed up at 2, 4, and 8 weeks after treatment. All injections were performed using ultrasound guidance to insure proper placement of the therapeutic agent in the bursa.
Participants were asked to rate their degree of shoulder pain on a 0 to 10 scale and to answer a Shoulder Disability Questionnaire. They also were asked to move their shoulders slowly until they experienced pain, and evaluators measured the Active Range of Motion (AROM) in 4 different directions (forward flexion, abduction, internal rotation, and external rotation of the shoulder in a standing position).
Compared with pretreatment (within-group comparisons), the high- (40 mg) and low-dose corticosteroid (20 mg) groups both showed improvement in pain, disability, and AROM, while the placebo group showed no difference. Importantly, this study showed no significant inter-group differences between the high- and low-dose corticosteroid groups. Because a higher dose may increase the incidence of local and general complications, a lower dose is indicated at the initial treatment stage.
The article is "Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial" by Ji Yeon Hong, MD, Seung-Hyun Yoon, MD, PhD, Do Jun Moon, MD, Kyu-Sung Kwack, MD, PhD, Bohyun Joen, MD, and Hyun Young Lee, MS. It will appear in the Archives of Physical Medicine and Rehabilitation, Volume 92, Issue 12 (December 2011), published by Elsevier. doi:10.1016/j.apmr.2011.06.033.
Shannon Magee | EurekAlert!
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
19.10.2017 | Materials Sciences
19.10.2017 | Materials Sciences
19.10.2017 | Physics and Astronomy