Optimising exercise and corticosteroid injection for subacromial pain syndrome: a UK factorial randomised trial (bjsm.bmj.com)

• Physiotherapist-led exercise significantly improved SPADI at 6 months compared to leaflet (difference -8.23 points).
• Ultrasound-guided injection showed no advantage over unguided injection at 6 weeks, 6 months, or 12 months.
• Trial conducted in UK NHS with 256 participants.

"A 2×2 factorial RCT of 256 UK participants compared physiotherapist-led exercise vs exercise leaflet and ultrasound-guided vs unguided corticosteroid injection for subacromial pain syndrome. Physiotherapist-led exercise significantly improved SPADI score at 6 months (mean difference -8.23; 95% CI -14.14 to -2.32). Ultrasound guidance provided no benefit over unguided injection at any time point."