Retrospective evaluation of ultrasound-guided shoulder injections in patients with shoulder pain and movement restriction

Objective: We aimed to retrospectively evaluate the effect of subacromial steroid injection (SSI) guided by ultrasonography (USG) on pain and functional status, and to assess the factors influencing the response to treatment. Materials and Methods: The study was designed as a single-center, retrospective time-limited clinical study. Between May 1, 2020, and May 1, 2021, 55 patients who presented with shoulder pain and restricted motion underwent SSE guided by USG at the Department of Physical Medicine and Rehabilitation, Farabi Hospital, Karadeniz Technical University Faculty of Medicine. Data including Visual Analog Scale (VAS) score, Constant Murley shoulder score, Shoulder Pain and Disability Index (SPADI) score, and shoulder joint range of motion (ROM) goniometric measurements were recorded from the electronic medical records of patients obtained from the hospital's database before the injection, 30 minutes after the injection, and 3 weeks later. Changes in VAS score, Constant Murley shoulder score, SPADI score, and shoulder ROM from before the injection to 3 weeks after the injection were used to evaluate treatment efficacy. Patients were divided into different subgroups to assess potential factors influencing the effectiveness of SSI. Results: The average age of the 55 patients included in the study was 57.9±12.0 years. The percentage of female patients was 70.9%, while the percentage of homemakers was 54.5%. Additional diseases were observed in 63.6% of the patients, with hypertension and diabetes being the most common comorbidities. Preand post-treatment evaluations revealed significant changes in VAS score and shoulder ROM from baseline to 30 minutes and from baseline to 3 weeks in all groups (p<0.05). Similarly, statistically significant changes were observed in night pain VAS score and the number of individuals experiencing disrupted sleep due to pain from baseline to 3 weeks in all groups (p<0.05). Significant increases were noted from baseline to 3 weeks in VAS, Constant Murley, SPADI score, and shoulder ROM in patients aged 60 years and younger, those with symptom duration of less than 12 weeks, those without a history of trauma, and those with subacromial bursitis observed on ultrasound compared to their respective counterparts (p<0.05). However, there was no statistically significant relationship found between gender, obesity, additional diseases, affected dominant shoulder, educational status, etiology, extrarotator cuff pathology, simultaneous multiple injections, and partial thickness rotator cuff tears with the efficacy of subacromial steroid injection (p>0.05). Conclusion: In conclusion, this study supports SSI as a safe and effective treatment option for patients with shoulder pain. It also demonstrates that the duration of symptoms, patient's age, history of trauma, and the presence of subacromial bursitis on ultrasound influence the response to treatment.