It's frustrating to see another "either-or" piece rather than a study that includes, as a third arm, the standard of treatment in a clinical sports medicine practice. In this condition that would include a guided subacromial injection followed by home and office PT.
Physical Therapy and Steroids Similarly Effective for Shoulder Pain — Physician’s First Watch
Physical Therapy and Steroids Similarly Effective for Shoulder Pain
By Amy Orciari Herman
Edited by Jaye Elizabeth Hefner, MD
For patients with shoulder impingement syndrome, physical therapy and corticosteroid injections offer similar relief, but injections lead to more healthcare utilization, according to an Annals of Internal Medicine study.
Some 100 adults with unilateral shoulder impingement syndrome at one military medical center were randomized to receive either subacromial injection of triamcinolone acetonide (40 mg; up to 3 injections over 1 year), or physical therapy (6 sessions over 3 weeks) plus home exercises.
At 1 year, both groups had achieved a 50% improvement in average pain and disability score, with no significant differences between the groups at any time during the study. However, the steroid group had more primary care visits for shoulder pain and more additional steroid injections than the physical therapy group.
Editorialists write: "In choosing a management plan, clinicians should consider patient preference, availability of practitioners, and other health care use... If the patient prefers a corticosteroid injection, its effectiveness, safety profile, and potential for additional health care should be discussed."