If you’ve been struggling with subacromial shoulder pain (often felt when lifting your arm, reaching, or lying on that side), it can be difficult to know which treatment is best. This large study looked at two of the most common options so you can understand what is most likely to help you.
- Guided, personalised physio exercises give better results
One group received individualised physiotherapy sessions, where exercises were tailored and progressed week by week. The other group was simply given an exercise leaflet.
What happened?
● The physio-led group improved more and faster
● They reported less pain and better shoulder function at 6 months
● People stuck to their exercises better when they had support
This means:
You’re more likely to reduce pain and get your arm moving properly when a physiotherapist guides your
programme rather than trying exercises alone.
2. Ultrasound-guided injections are not better than standard injections
Many people assume that injections done with ultrasound must be more effective. This study found something surprising:
● Pain and function improved just as much with a standard injection
● Ultrasound guidance didn’t lead to better results at 6 weeks, 6 months, or 12 months
This means:
A standard, well-performed injection is usually enough, you don’t need ultrasound for the injection to “work”.
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3. Most people improve without needing anything invasive
Across all groups, people reported improvements over time. Temporary pain after injection was common (around half), but serious problems were extremely rare.
This means:
Shoulder pain is treatable, and with the right exercises and support, most people can expect the shoulder to
settle without complicated procedures.
What This Means for You
● Physio exercises that are tailored to you give the best chance of long-term improvement
● A simple shoulder injection is as effective as an ultrasound-guided one
● Consistency matters, sticking to your exercises helps the improvement last
● You’re not alone, shoulder pain is common, and most people recover with good guidance
Takeaway
If you’re dealing with shoulder pain, the best approach is a structured physiotherapy programme, supported by a clinician who can progress your exercises and keep you on track. Injections can help too, but they don’t need to be done under ultrasound to be effective.
This study gives confidence that with the right support, you can regain strength, movement, and comfort in your shoulder.
Newsletter By: Emre Oz (Specialist MSK Physiotherapist/Head of Integrated MSK & Sports Medicine Operations at Crouch Physio).
Reference
- Roddy, Edward, et al. “Optimising outcomes of exercise and corticosteroid injection in patients with subacromial pain (impingement) syndrome: a factorial randomised trial.” British Journal of Sports Medicine 55.5 (2021): 262-271.
