title: Impingement syndrome: temporal outcomes of nonoperative treatment.
abstract: OBJECTIVE
  We prospectively studied patients with impingement syndrome to look at outcomes of nonoperative treatment on a temporal basis.
  
  
  METHODS
  Temporal outcomes of 100 consecutive patients treated for impingement syndrome were prospectively evaluated. All patients began a standardized, nonoperative treatment protocol consisting of a subacromial steroid injection, followed by physical therapy.
  
  
  RESULTS
  Data were available on 94 patients at the final two-year follow-up assessment. Overall, 74 of 94 patients did not require surgery. In that group, the average American Shoulder and Elbow Surgeons (ASES) outcome score increased from 56 to 95, with an average decrease in the pain score from 4.8 to 0.6. Improvement was demonstrated in patient shoulder outcome scores (ASES score) and visual analog pain scores between treatment initiation and the one-year follow-up assessment (p < .0001); no improvement was identified past one year. Of the non-surgical patients, 22 continued to have some shoulder pain.
  
  
  CONCLUSIONS
  Of patients with impingement syndrome treated nonoperatively, 79% did not require surgery after two-year follow-up. Predictors of patients going on to surgical intervention included the total number of subacromial steroid/lidocaine injections and patient response to the initial subacromial injection. Of the patients not undergoing surgery, 30% continued to have some shoulder pain.
  
  
  METHODS
  Level 1; Prospective prognosis study, >80% follow-up.
authors.affiliation: Lake Cook Orthopaedic Associates, Barrington, IL 60010, USA. ccraigacummins@hotmail.com
authors.forename: Craig A
authors.initials: CA
authors.lastname: Cummins
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sasso
authors.forename: Daniel
authors.initials: D
authors.lastname: Nicholson
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D015552:Injections, Intralesional; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D019534:Shoulder Impingement Syndrome / Q000628:therapy*; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013256:Steroids