AMSSM Sports Medcasts Top Sports Medicine Articles Podcast – NSAIDs vs. Steroid Injections for Shoulder Impingement Syndrome
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Dec 11, 2024 Dr. Jason Deck, an Associate Professor and director of the Primary Care Sports Medicine Fellowship at the University of Oklahoma, dives into the effectiveness of NSAIDs versus corticosteroid injections for shoulder impingement syndrome. He reviews a significant meta-analysis highlighting treatment outcomes and cost implications. The conversation explores the nuances of the research, the challenges of comparing treatments, and how patient-specific factors like diabetes influence choices. It's a critical discussion for anyone involved in sports medicine!
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Initial Approach to Shoulder Impingement
- Start with a thorough physical exam and history, including Neer and Hawkins tests.
- Consider conservative treatments like physical therapy, rest, and oral anti-inflammatories initially.
Study Selection and Quality
- Ten randomized controlled trials (RCTs) were included in the meta-analysis, comparing NSAID and steroid injections.
- Seven studies were high quality, and three were good quality based on risk and bias assessment.
Patient Demographics and Outcomes
- The meta-analysis included 694 patients with an average age of 46 years (ranging from 30 to 60).
- Both pain and function were assessed, using visual analog scales, Constant-Murley scores, and UCLA shoulder scales.