Comparison of corticosteroid injection, physiotherapy and combined treatment for patients with chronic subacromial bursitis – A randomised controlled trial

Objective To investigate whether combination of corticosteroid subdeltoid injections and physiotherapy was more effective than either treatment alone in chronic subacromial bursitis. Design Prospective, three-arm randomised controlled trial. Setting Rehabilitation department of an academic hospital. Subjects Patients with chronic subacromial bursitis. Interventions Patients were divided into corticosteroid injection (N = 36), physiotherapy (N = 40) and combined (N = 35) groups. Two corticosteroid subdeltoid injections in corticosteroid group, 8-week physical therapy emphasising on therapeutic exercise in physiotherapy group, and combined both treatments in combined group. Main outcome measures The primary outcome measures were pain visual analogue scale and Shoulder Pain and Disability Index at 8 weeks after finishing treatment. The secondary outcome measures were active range of motion, Shoulder Disability Questionnaire, Western Ontario Rotator Cuff Index, patient's evaluation of treatment effect, and symptom recurrence. Results Group comparison showed significant statistical difference in shoulder flexion (P