How are corticosteroids and procedures used in the acute phase of rotator cuff treatment?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

Corticosteroids delivered directly to the site via injection can be considered to allow further progression of the rehabilitation program. Place injections into the subacromial space, avoiding direct injection into the rotator cuff tendon. Advise the patient to limit activity that involves high-tensile loads (eg, maximal overhead throwing) for 2-3 weeks while the tendon is potentially at risk after injection, particularly if the patient exhibits rotator cuff muscle weakness. These injections need not be given to patients with complete rotator tears, especially if surgery is being considered.

A systematic review by Louwerens et al found that high-energy extracorporeal shockwave therapy, ultrasound-guided needling and arthroscopy all had positive outcomes for the treatment of calcific tendinopathy of the rotator cuff. [27]


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