Impingement syndrome: Temporal outcomes of nonoperative treatment

Journal of Shoulder and Elbow Surgery (Dec 2008) Cummins CA, Sasso LM, Nicholson D;

Temporal outcomes of 100 consecutive patients treated for impingement syndrome were prospectively evaluated. All patients began a standardized, nonoperative treatment protocol consisting of a subacromial steroid injection, followed by physical therapy. Data were available on 94 patients at the final 2-year follow-up assessment. Overall, 74 of 94 patients did not require surgery. In that group, the average American Shoulder and Elbow Surgeons (ASES) outcome score increased from 56 to 95, with an average decrease in the pain score from 4.8 to 0.6. Improvement was demonstrated in patient shoulder outcome scores (ASES score) and visual analog pain scores between treatment initiation and the 1-year follow-up assessment (P<.0001); no improvement was identified past 1 year. Of the nonsurgical patients, 22 continued to have some shoulder pain. Predictors of patients going on to surgical intervention included the total number of subacromial steroid/lidocaine injections and patient response to the initial subacromial injection.