| Methods |
Randomised, controlled trial.
Blinding: both participants and outcome assessors were blinded.
Loss to follow‐up: 0 patients
Appropriate statistical analysis: yes, intention to treat analysis. |
| Participants |
60 patients.
Inclusion criteria: symptoms less than 3 months and rotator cuff tendonitis according to Cyriax's criteria:
1. pain exacerbated by: resisted movement: on abduction (supraspinatus tendinitis) with a painful arc; on external rotation (infraspinatus tendinitis)
2. active range frequently limited by pain and passive range always > active range of movement
3. normal glenohumeral range of passive movement
Exclusion criteria: Systemic inflammatory arthropathy; recent peptic ulceration or gastrointestinal bleeding or sensitivity to NSAID or triamcinolone; shoulder injection within previous 3 months; glenohumeral arthritis, acromioclavicular arthritis, bicipital tendinitis or a suspected rotator cuff tear (weak arm elevation, positive "drop arm sign" or a high riding humerus seen radiologically); local infection.
NSAIDs stopped at least one week before study entry. |
| Interventions |
Group 1(20 patients): 50 mg diclofenac 3 times a day for 28 days + subacromial injection of 3ml of 0.5% lignocaine
Group 2 (20 patients): diclofenac placebo tablets + subacromial injection of 2ml 0.5% lignocaine & 1ml of 80mg/ml triamcinolone hexacetomide.
Group 3 (20 patients): diclofenac placebo tablets + subacromial injection of 3ml 0.5% lignocaine.
All patients instructed in pendulum and wall climbing exercises to perform at home. |
| Outcomes |
Outcome assessed at baseline and 4 weeks
1) Overall pain severity assessed by 10cm VAS (0 = no pain, 10 = severe pain)
2) Limitation of function on 4‐point scale (0 = no 1 = mild, 2 = moderate and 3 = severe limitation of function respectively)
3) Range of active and passive shoulder movement measured to the nearest 5 degrees with a pendulum goniometer. |
| Notes |
See analyses 2, 11.
Standard error of means converted to standard deviations. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
