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 .
Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial
Objective To compare the effectiveness of subacromial corticosteroid injection combined with timely exercise and manual therapy ( injection plus exercise ) or exercise and manual therapy alone ( exercise only ) in patients with subacromial impingement syndrome . Design Pragmatic r and omised clinical trial . Setting Primary care based musculoskeletal service . Patients Adults aged 40 or over with subacromial impingement syndrome with moderate or severe shoulder pain . Interventions Injection plus exercise or exercise only . Main outcome measures Primary outcome was the difference in improvement in the total shoulder pain and disability index at 12 weeks . Results 232 participants were r and omised ( 115 to injection plus exercise , 117 to exercise only ) . The mean age was 56 ( range 40 - 78 ) , 127 were women , and all had had a median of 16 weeks of shoulder pain ( interquartile range 12 - 28 ) . At week 12 there was no significant difference between the groups in change in total pain and disability index ( mean difference between change in groups 3.26 ( 95 % confidence interval −0.81 to 7.34 ) , P=0.116 ) . Improvement was significantly greater in the injection plus exercise group at week 1 ( 6.56 , 4.30 to 8.82 ) and week 6 ( 7.37 , 4.34 to 10.39 ) for the total pain and disability index ( P<0.001 ) , with no differences at week 24 ( −2.26 , −6.77 to 2.25 , P=0.324 ) . Conclusions In the treatment of patients with subacromial impingement syndrome , injection plus exercise and exercise only are similarly effective at 12 weeks . Trial registration IS RCT 25817033 ; EudraCT No 2005 - 003628 - 20
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 .