ultrasound-guided ozone (O2-O3) vs corticosteroid injection in patients with shoulder impingement
Introduction Ozone has been recently used as a safe alternative treatment in musculoskeletal disorders with fewer side effects than corticosteroids. The aim of this study was to compare the efficacy of a single injection of ozone with that of a corticosteroid in the treatment of shoulder impingement. Design 30 patients with shoulder pain and clinical signs and symptoms of impingement were randomly assigned into two groups: ultrasound-guided injection with ozone or corticosteroid. Patients' symptoms were evaluated by Visual Analog Scale (VAS), Constant score, Shoulder Pain and Disability Scale (SPADI), shoulder range of motion (ROM) and ultra-sonographic measures before treatment, two weeks and two months after injections. Results Patients’ VAS, SPADI and Constant score improved significantly in both groups (P<0.001), but the benefits were in favor of corticosteroid group (P<0.001). At intervals between the two follow-ups, an improvement was observed in the VAS score among patients receiving ozone, while during the same interval, patients’ pain slightly worsened in the corticosteroid group. The ROM and ultra-sonographic measures did not show statistical differences between the two groups. Conclusion Corticosteroid injection improves the pain and disability scores more significantly than a one-time ozone injection. Ozone may serve as an alternative modalities in treating shoulder impingement when the use of steroids is contraindicated. *Corresponding author: Mohamad Sadegh Khabbaz All correspondence should be addressed to: Mohamad Sadegh Khabbaz, MD. Department of Physical Medicine and Rehabilitation, Firoozgar hospital, Valieasr square, Tehran, Iran. Fax: +98[21]88942970, Tel: +98[21]88908519, Mobile: +989120766393, E-mail: m.sadegh.khabbaz@gmail.com Author Disclosures: There is no conflict of interest. No funding or grants or equipment provided for the project from any source and there are no financial benefits to the authors. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Introduction Ozone has been recently used as a safe alternative treatment in musculoskeletal disorders with fewer side effects than corticosteroids. The aim of this study was to compare the efficacy of a single injection of ozone with that of a corticosteroid in the treatment of shoulder impingement. Design 30 patients with shoulder pain and clinical signs and symptoms of impingement were randomly assigned into two groups: ultrasound-guided injection with ozone or corticosteroid. Patients' symptoms were evaluated by Visual Analog Scale (VAS), Constant score, Shoulder Pain and Disability Scale (SPADI), shoulder range of motion (ROM) and ultra-sonographic measures before treatment, two weeks and two months after injections. Results Patients’ VAS, SPADI and Constant score improved significantly in both groups (P<0.001), but the benefits were in favor of corticosteroid group (P<0.001). At intervals between the two follow-ups, an improvement was observed in the VAS score among patients receiving ozone, while during the same interval, patients’ pain slightly worsened in the corticosteroid group. The ROM and ultra-sonographic measures did not show statistical differences between the two groups. Conclusion Corticosteroid injection improves the pain and disability scores more significantly than a one-time ozone injection. Ozone may serve as an alternative modalities in treating shoulder impingement when the use of steroids is contraindicated. *Corresponding author: Mohamad Sadegh Khabbaz All correspondence should be addressed to: Mohamad Sadegh Khabbaz, MD. Department of Physical Medicine and Rehabilitation, Firoozgar hospital, Valieasr square, Tehran, Iran. Fax: +98[21]88942970, Tel: +98[21]88908519, Mobile: +989120766393, E-mail: m.sadegh.khabbaz@gmail.com Author Disclosures: There is no conflict of interest. No funding or grants or equipment provided for the project from any source and there are no financial benefits to the authors. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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