Chronische pijn in de schouder Painful Arc Syndrome Subacromial Impingement Syndrome
Conditions
Interventions
In a randomised sequence, participants will receive two US-guided subacromial
injections: one with anaesthetics (5cc lidocaine 1%, using a 50 mm 21 gauge
needle) and one with a placebo (5cc NaCl 0.9
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - Chronic shoulder pain (>3 months) - Unilateral shoulder pain - Suspicion of subacromial origin of pain (e.g. positive painful arc test, Hawkins-Kennedy test, empty can test) - Presence of conventional ultrasonography - Presence of conventional radiographs
Exclusion criteria
Exclusion criteria: - Younger than 18 years of age - Tendinitis calcarea - Full thickness rotator cuff tear - Suspicion of capsulitis adhesiva after clinical examination - Glenohumeral osteoarthritis - Medication that potentially act on central pain sensitisation (e.g. pregabalin, amitriptylin, duloxetine) - Use of opioid analgesics, e.g. oxycodone. - Suspicion of symptomatic acromioclavicular osteoarthritis (e.g. positive cross body adduction test) - History of fractures or dislocations of the shoulder - Cardiac disease - Comorbidities: neurological disorders (e.g. plexus lesion), rheumatic disorders (e.g. polymyalgia rheumatic), muscle dystrophies, metabolic disorders (e.g. hypothyreodism), neoplasms - Diagnosed with other chronic pain syndrome, e.g. diabetic polyneuropathy, chronic low back pain or fibromyalgia - Insufficient Dutch language skills - No informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary study paramaters are: 1) the effect of subacromial injections on pain at rest and during abduction assessed with a visual analogue scale (VAS), 2) CPS assessed with bilateral Quantitative Sensory Testing (QST). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary study parameters (determinants) are two anchor questions for pain, assessment of succesful blinded allocation, shoulder muscle activation ratios (ARs), findings from ultrasonography, questionnaires and demographics and will be used to assess factors that are associated with pain in SAPS. | — |
Countries
Netherlands
Outcome results
None listed