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manual therapy vs steriod injections

Manual Therapy vs Steroid Injections

Which Is Better for Shoulder Impingement Syndrome?

Military hospital studies are great for comparing similar patients, which is why I liked this study of over 100 cases comparing non-surgical approaches to a common shoulder problem.

Manual Therapy and Steroid Injections were tied for short term pain relief (with the limits of significance).  However, during the 1-year follow-up:

  • Patients who received steroid injections required additional visits to their primary care provider for shoulder issues more frequently (60% vs. 37% – a dramatic difference!) 
  • They were also nearly twice as likely to require additional steroid injections (38% vs. 20%) 

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Rhon, D. I., Boyles, R. B., & Cleland, J. A. (2014). One-year outcome of subacromial corticosteroid injection compared with manual physical therapy for the management of the unilateral shoulder impingement syndrome: A pragmatic randomized trial. Annals of Internal Medicine, 161(3), 161-9. doi:10.7326/M13-219.  Retrieved from


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