Comparison of Subacromial Ketorolac Injection Vs Subacromial Steroid Injection in the treatment of Shoulder Impingement Syndrome

Aim: To compare the outcome of subacromial ketorolac injection versus subacromial steroid injection in Shoulder Impingement Syndrome. Methodology: This randomized controlled trial was done at the Department of Orthopedics Unit II, Mayo Hospital, Lahore from 26th April 2018 to 25th October 2018. The sample size was 218patients 15 to 60 years of age with shoulder impingement syndrome, were included and patients with a fracture or rotator cuff tear who presented with weakness and muscle wasting, taking regular systemic NSAIDs or steroids, history of gastrointestinal (GI) ulcers and bleeding disorders were excluded. Randomization was done by lottery method.Group A (ketorolac group) was given a single injection of 60 mg ketorolac mixed with 1 ml 2% lidocaine and Group B (steroid group) was given 40 mg methylprednisolone mixed with 1ml 2% lidocaine. All patients were followed up on 4th weeks. Results: Out of 218 patients, 117(53.67%) were males and 101(46.33%) were females with a male to female ratio of 1.2:1. The mean age of patients in group A was 39.09 +/- 9.90years and in group, B was 38.08 +/- 8.61years. The mean post-injection VAS score in group A was 2.80 +/- 0.94 and in a group, B was 4.20 +/- 0.98 with a p-value of <0.001. The mean post-injection constant score in group A was 31.59 +/- 6.86 and in group, B was 41.31 +/- 4.56 with a p-value of <0.001. Conclusion: Sub-acromial ketorolac injection showed a better mean pain score and constant score than subacromial steroid injection in patients with shoulder impingement syndrome.