Treatment of shoulder complaints in general practice: long term results of a randomised, single blind study comparing physiotherapy, manipulation, and corticosteroid injection

Descriptive studies have shown that shoulder complaints can be persistent and recurrent, requiring long term evaluation of treatment.1 Unfortunately, in most randomised studies comparing treatments for shoulder complaints the study period varies from a few weeks (trials of non-steroidal anti-inflammatory drugs) to 3-6 months (injection therapy and physiotherapy trials).2–4) In a trial in 1994-5 of treatment of shoulder complaints in general practice we showed that in a study period of 11 weeks, injection therapy with a corticosteroid was superior to physiotherapy and manipulative therapy in the patients whose complaints originated from the structures of the glenohumeral joint, the subacromial space, or the acromioclavicular joint (synovial group).5 In the patients whose complaints related to functional disorders of the cervical spine, the upper thoracic spine, or the adjoining ribs (shoulder girdle group), manipulation was superior to physiotherapy. To assess the various treatments in …