In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Corticosteroid injection for shoulder pain: single-blind randomized pilot trial in primary care
Background Shoulder pain is a very common presentation in primary care . Evidence of benefit for subacromial corticosteroid injection is inconclusive and confined largely to studies with short follow-up . We plan a large , definitive , primary -care-based trial to determine efficacy and safety in patients with rotator cuff tendinopathy , and conducted a pilot trial to explore feasibility . Methods Six general practitioners ( GPs ) from Oxfordshire , UK underwent up date training in assessing painful shoulders and injecting the subacromial space . Each then recruited patients aged 35 to 74 years from primary care complaining of shoulder pain lasting no more than 6 months . Eligible participants were r and omized to receive either methylprednisolone acetate 40 mg with lidocaine 1 % ( total volume 1 ml ) , or lidocaine 1 % alone ( total volume 1 ml ) , injected into the subacromial space . The participants were blinded to treatment allocation . Feasibility outcomes were rates of recruitment , withdrawal , adherence to the protocol , completeness of follow-up , and success of patient masking . Clinical outcomes were the Oxford Shoulder Score ( OSS ) at baseline and at 4 and 12 weeks , and responses to three satisfaction questions at 2 , 4 and 12 weeks . Outcome data were collected by postal question naires . Results A total of 40 participants were r and omized ( 80 % of the target 50 participants ) over 26 weeks giving an overall recruitment rate  of 1.5 participants per week . Rates of follow-up were maintained to a high level for the full 12 weeks . Four participants requested a ‘ rescue ’ corticosteroid injection but no patients withdrew . The trial GPs gave high scores for their confidence that the patient had remained blinded to treatment allocation during the procedure . The OSS at 4 and 12 weeks and the responses to the satisfaction questions are reported . Conclusions It is feasible to recruit participants with shoulder pain in the primary care setting for a blinded , r and omized trial of corticosteroid injection . Online r and omization of participants from the practice is also feasible , and postal question naires provide an effective means of gathering outcome data in this area of study . The lessons learned from this pilot will usefully inform the design of a large , definitive efficacy trial in primary care . Trial registration Current Clinical Trials IS RCT
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .