Shoulder Pain Clinical Trial
Official title:
The Efficacy of Local Anesthetics to Reduce Shoulder Pain Post-Steroid Injections
The specific aim of this prospective study is to determine whether local anesthetics prior to subacromial steroid injections reduce pain and consequently if they are cost-effective in the treatment for shoulder pathology.
Shoulder pain is a common problem that can be estimated to be prevalent in up to 15 percent
of the patient population registered to general practices and is second only to back pain in
patients seeking treatment for musculoskeletal issues in the primary care setting. As a
common source of distress, shoulder pain contributes significantly to health care costs.
Rotator cuff disease due to impingement, tendonitis or bursitis is a frequent cause of
shoulder pain and dysfunction. Initial treatment consists of a conservative approach of
activity modification, oral nonsteroidal anti-inflammatory drugs (NSAIDs) and supervised
physical therapy. However, if the patients' symptoms persist, subacromial injections of a
local anesthetic such as lidocaine, and a corticosteroid may be indicated as a sequential
treatment option.
The steroid injection itself can be a painful process, so administering a local anesthetic
prior to the steroid injection is thought to mitigate pain or reduce possible discomfort
during and immediately following the procedure. Though there is evidence advocating for the
benefits of combining local anesthetics and corticosteroids for the treatment of subacromial
pathologies, it is not conclusive whether local anesthesia significantly enhances the pain
relieving effect of steroids. Should local anesthesia not have a significant impact on the
patient's pain intensity, then the use of corticosteroids alone could potentially result in
reduced costs in care.
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