University of Hertfordshire

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Original languageEnglish
Pages (from-to)497-504
Number of pages8
JournalBritish Journal of Sports Medicine
Early online date5 Jan 2018
Publication statusPublished - 1 Apr 2018


Objective To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP). Design Systematic review with best evidence synthesis. Data sources The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Reference lists of included articles were also hand searched. Eligibility criteria Two reviewers independently evaluated eligibility. Randomised controlled trials (RCTs) were included if they compared subacromial injections of corticosteroid with anaesthetic injections. Two reviewers independently extracted data regarding short-term, midterm and long-term outcomes for pain, self-reported function, range of motion and patient-perceived improvement. Results Thirteen RCTs (n=1013) were included. Four trials (n=475) were judged as being at low risk of bias. Three studies of low risk of bias favoured the use of corticosteroid over anaesthetic-only injections in the short term (up to 8 weeks). There was strong evidence of no significant difference between injection types in midterm outcomes (12-26 weeks). There was limited evidence of no significant difference between injection types in long-term outcomes. Conclusion Corticosteroid injections may have a short-term benefit (up to 8 weeks) over local anaesthetic injections alone in the management of RCRSP. Beyond 8 weeks, there was no evidence to suggest a benefit of corticosteroid over local anaesthetic injections. Trial registration number PROSPERO CRD42016033161.


This is the accepted version of the following article: Tim Cook, Catherine Minns Lowe, Mark Maybury, and Jeremy S. Lewis, ‘Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review’, British Journal of Sports Medicine, April 2018, which has been published in final form at Published by BMJ Journals. © 2018 The Author(s). Content in the UH Research Archive is made available for personal research, educational, and non-commercial purposes only. Unless otherwise stated, all content is protected by copyright, and in the absence of an open license, permissions for further re-use should be sought from the publisher, the author, or other copyright holder.

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