Sarah Morton1, Otto Chan2, Asser Ghozlan1, Jessica Price1, John Perry3, Dylan Morrissey4. 1. Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK. 2. BMI London Independent Hospital, London, UK. 3. Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK ; BMI London Independent Hospital, London, UK. 4. Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK ; BMI London Independent Hospital, London, UK ; Physiotherapy Department, Bart's Health NHS Trust, London, UK.
Abstract
BACKGROUND: the aim was to establish the effect of a high volume-image guided injection and structured rehabilitation (HVIGI&SR) on both pain and function in shoulder impingement syndrome (SIS). METHODS: 44 participants treated between January 2008 and January 2012 with a >3 month history of recalcitrant ultrasound-confirmed SIS were sent a retrospective questionnaire. All participants had received a HVIGI under ultrasound-guidance consisting of 20 mls of Marcaine with 50 mg of hydrocortisone, followed by a period of physiotherapist-led rehabilitation. The validated Shoulder Pain and Disability Index (SPADI) score was used to establish the change in the score between 1 week pre-injection and 3 weeks post-injection, along with an 11-point pain scale. RESULTS: 59% of participants responded. There was a clinically and statistically significant decrease in the SPADI score of 58.7 ± 29.9 (p<0.01). 76% of participants had an improvement in their score of over 50% from their initial score. There was a clinically and statistically significant improvement in pain of 5.19 ± 2.62 (p<0.01) on the numerical rating scale of pain. CONCLUSION: HVIGI&SR should be considered for short-term treatment of SIS as it showed a significant improvement in both pain and function. A prolonged period of physiotherapist-led rehabilitation can then be undertaken for long term benefits.
BACKGROUND: the aim was to establish the effect of a high volume-image guided injection and structured rehabilitation (HVIGI&SR) on both pain and function in shoulder impingement syndrome (SIS). METHODS: 44 participants treated between January 2008 and January 2012 with a >3 month history of recalcitrant ultrasound-confirmed SIS were sent a retrospective questionnaire. All participants had received a HVIGI under ultrasound-guidance consisting of 20 mls of Marcaine with 50 mg of hydrocortisone, followed by a period of physiotherapist-led rehabilitation. The validated Shoulder Pain and Disability Index (SPADI) score was used to establish the change in the score between 1 week pre-injection and 3 weeks post-injection, along with an 11-point pain scale. RESULTS: 59% of participants responded. There was a clinically and statistically significant decrease in the SPADI score of 58.7 ± 29.9 (p<0.01). 76% of participants had an improvement in their score of over 50% from their initial score. There was a clinically and statistically significant improvement in pain of 5.19 ± 2.62 (p<0.01) on the numerical rating scale of pain. CONCLUSION: HVIGI&SR should be considered for short-term treatment of SIS as it showed a significant improvement in both pain and function. A prolonged period of physiotherapist-led rehabilitation can then be undertaken for long term benefits.
Authors: Edward G McFarland; Nicola Maffulli; Angelo Del Buono; George A C Murrell; Juan Garzon-Muvdi; Steve A Petersen Journal: Muscles Ligaments Tendons J Date: 2013-08-11
Authors: Sarah Morton; Otto Chan; John King; David Perry; Tom Crisp; Nicola Maffulli; Dylan Morrissey Journal: Muscles Ligaments Tendons J Date: 2014-07-14
Authors: Sarah Morton; Otto Chan; Jessica Price; Melanie Pritchard; Tom Crisp; John D Perry; Dylan Morrissey Journal: Muscles Ligaments Tendons J Date: 2015-07-03