Evidence map›Paper›PMID 15808040›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2005

Corticosteroid injections for painful shoulder: a meta-analysis.

Bruce Arroll, Felicity Goodyear-Smith

3 registry-linked trialsOpen access · greenAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 79 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 12 pooled it
7.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01190891 nacompletednot on this mapstarted 2010, after this paper: background citation

A Manual Physical Therapy Approach Versus Subacromial Corticosteroid Injection for Treatment of Shoulder Impingement Syndrome: a Randomized Clinical Trial

TypeinterventionalSponsorMadigan Army Medical CenterRan2010 to 2013Enrolled104ConditionsShoulder Impingement SyndromeArmsManual Physical Therapy, Corticosteroid Injection
NCT03752619 nacompletednot on this mapstarted 2019, after this paper: background citation

Peripheral Nerve Stimulation(PNS) for Subacromial Impingement Syndrome(SIS)

TypeinterventionalSponsorMetroHealth Medical CenterRan2019 to 2024Enrolled116ConditionsShoulder Pain, Shoulder Impingement Syndrome, Shoulder Tendinitis, Shoulder BursitisArmsContracting Producing Peripheral Nerve Stimulation, Non Contracting Producing Peripheral Nerve Stimulation, Physical Therapy
NCT06856824 narecruitingnot on this mapstarted 2024, after this paper: background citation

Functional Results of Infiltration for Biceps Tendonitis Guided by Ultrasound vs Anatomical Repairs: Variation in Technique

TypeinterventionalSponsorHospital Universitario San IgnacioRan2024 to 2025Enrolled50ConditionsBíceps TendinitisArmsinjection in the bicipital groove guided by anatomic landmarks, injection in the bicipital groove guided by ultrasound
3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 12 syntheses or guidelines pooled it, 278 citations in OpenAlex.

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  11. Arthrographic distension for adhesive capsulitis (frozen shoulder).The Cochrane database of systematic reviews · 2008
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  12. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007
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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Bruce ArrollDepartment of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, PB 92019, Auckland, New Zealand. b.arroll@auckland.ac.nz
Felicity Goodyear-Smith
Primary Health Care · QAUniversity of Auckland · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are no systematic reviews of corticosteroids for shoulder pain that calculate the numbers needed to treat.

aimWe wished to determine the effectiveness in terms of improvement of symptoms of intra-articular and subacromial injections of corticosteroid for rotator cuff tendonitis and frozen shoulder. DESIGN OF STUDY: Systematic review and meta-analysis of randomised controlled trials.

methodData sources included the Cochrane Controlled Trials Register, Medline, EMBASE, hand searches and author contacts. The review methods required any randomised controlled trial in which the effectiveness of subacromial or intra-articular steroid injections versus placebo and versus non-steroidal anti-inflammatory medication, could be ascertained. The outcome was improvement of symptoms. The data abstraction was done independently, as was the validity assessment. The data was pooled using Review Manager 4.1.

resultsSeven studies were reviewed for corticosteroids versus placebo and three for corticosteroids versus nonsteroidal anti-inflammatory drugs (NSAIDs). The relative risk for improvement for subacromial corticosteroid injection for rotator cuff tendonitis was 3.08 (95% confidence interval [CI] = 1.94 to 4.87). The number needed to treat based on the pooled relative risk was 3.3 (95% CI = 1.8 to 7.7) patients to obtain one improvement. The relative risk for high dose (50 mg of prednisone or more) was 5.9 (95% CI = 2.8 to 12.6). The relative risk for improvement with steroids compared with NSAIDs was 1.43 (95% CI = 0.95 to 2.16). The number needed to treat for corticosteroids versus NSAIDs was 2.5 (95% CI = 1 to 9) for one significant study. The relative risks for intra-articular steroid injection for rotator cuff tendonitis were not statistically significant.

conclusionSubacromial injections of corticosteroids are effective for improvement for rotator cuff tendonitis up to a 9-month period. They are also probably more effective than NSAID medication. Higher doses may be better than lower doses for subacromial corticosteroid injection for rotator cuff tendonitis.

Indexed as

Adrenal Cortex HormonesAnti-Inflammatory Agents, Non-SteroidalHumansInjections, Intra-ArticularRandomized Controlled Trials as TopicRisk FactorsRotator CuffShoulder Impingement SyndromeShoulder PainTendinopathyTreatment OutcomeAdrenal Cortex HormonesAnti-Inflammatory Agents, Non-Steroidal

Identifiers

PMID15808040
PMCPMC1463095
OpenAlexW2124345737

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.