Exercise Therapy and Ultrasound Guided Injections in Painful Shoulder
Condition: Shoulder Bursitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      Many patients experience an effect of steroid injection, however the effect is often short
      lasting and recurrence of symptoms is common. The short term effect of injection has been
      shown to be much better than exercise therapy; however over time the superior effect of
      injection compared to exercise does not last. Injection in combination with exercise therapy
      might be a more sufficient therapy than injection alone. The aim of this study is to
      investigate a combination of steroid injection and a 10 week exercise program. In addition,
      the study tests the validity of clinical impingement tests using ultrasound verified
      impingement as gold standard.
    

Detailed description: 
      For many patients unspecific pain and reduced motion in the shoulder is a common complaint.
      It is believed that the main reason for shoulder pain comes from inflammation of the bursa.

      Many patients experience an effect of steroid injection, however the effect is often short
      lasting and recurrence of symptoms is common. Exercise therapy for the muscles around the
      shoulder joint is also common treatment for shoulder pain. The short term effect of injection
      has been shown to be much better than exercise therapy; however over time the superior effect
      of injection compared to exercise does not last. The anti-inflammatory and pain releasing
      effect of steroid injection in combination with exercise therapy increasing the strength and
      control of the muscles around the shoulder joint, might be a more sufficient therapy than
      injection alone. Thus, the aim of this study is to investigate a combination of steroid
      injection and a 10 week exercise program in patients with a painful shoulder.

      Many different clinical tests are used to examine the pathological compression of the bursa
      during motion in the shoulder joint (impingement). However, it is actually not known if the
      pain in motion is caused by compression of the bursa. Part of this study therefore is to test
      the validity of clinical impingement tests using ultrasound verified impingement as gold
      standard.

      Studies comparing injection given guided by ultrasound to blind injections have shown that
      the ultrasound guided injections are more likely to place the active stuff correctly in the
      swollen bursa. In this study all injections will be given ultrasound guided. In the
      ultrasound examination the thickness of the bursa will be measured in all patients in order
      to investigate if swollenness of the bursa can explained the pain and dysfunction of the
      shoulder joint
    

Intervention name(s): methylprednisolone
Intervention type(s): Other
Intervention description(s): Steroid injection X 2 and 10 weeks exercise program of painful shoulder vs exercise program of contralateral shoulder
Intervention MeSH terms: Methylprednisolone; Methylprednisolone Acetate; Methylprednisolone Hemisuccinate; Prednisolone; Prednisolone acetate; Prednisolone hemisuccinate; Prednisolone phosphate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Shoulder; Impingement; Ultrasound; injection of glucocorticosteroid; exercise