Effect of Ultrasound-Guided Subacromial Bursa Injections With Various Doses of Corticosteroid in Subacromial Bursitis: A Retrospective Study

TL;DR

This study compares low and high doses of corticosteroid injections for shoulder pain caused by subacromial bursitis, finding that higher doses provide longer-lasting relief.

Contribution

The study evaluates the effectiveness of varying corticosteroid doses in ultrasound-guided injections for subacromial bursitis, highlighting dose-dependent pain relief outcomes.

Findings

High-dose corticosteroid injections provided more significant and sustained pain relief compared to low-dose injections.

Both doses significantly reduced pain scores at all measured time points, with minimal adverse events.

Ultrasound guidance improved injection precision and safety in treating subacromial bursitis.

Abstract

Background: Subacromial bursitis is a common cause of shoulder pain and functional limitation, due to inflammation of the subacromial bursa. Corticosteroid injections are widely used in cases unresponsive to conservative treatments. However, the optimal dose for achieving sustained symptom relief with minimal adverse effects, especially when administered under ultrasound guidance, remains a topic of clinical interest. This study evaluates the efficacy of different corticosteroid doses delivered via ultrasound-guided subacromial bursa injection.

Methodology: This retrospective study was conducted at a tertiary care center between May 2018 and June 2023. Patients aged 30-60 years with MRI-confirmed subacromial bursitis who failed conservative treatment for at least three months were included. Subjects were divided into two groups: a low-dose group receiving 10 mg triamcinolone with 1% lignocaine and a high-dose group receiving 20 mg triamcinolone with 1% lignocaine. Injections were administered under ultrasound guidance using a linear probe. Pain was assessed using the Numerical Rating Scale (NRS) at baseline, and at one week, one month, three months, and six months post-intervention. Data were analyzed using t-tests and chi-square tests.

Results: Both groups showed significant reductions in pain scores at all post-injection time points (P < 0.05). The high-dose group demonstrated more substantial and sustained improvement in pain relief, with mean NRS scores decreasing from 8.1 at baseline to 2.4 at six months, compared to a decline from 7.9 to 3.5 in the low-dose group. Adverse events were minimal and similar across both groups.

Conclusions: Ultrasound-guided corticosteroid injections represent a safe and effective treatment for subacromial bursitis, with higher doses of triamcinolone offering longer-lasting pain relief. The technique improves precision and minimizes risk, making it a valuable tool in managing refractory shoulder pain. Further prospective studies are recommended to validate these findings and develop standardized dosing protocols.

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