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One group of patients received a subacromial corticosteroid injection of 40 mg of triamcinolone acetonide, while a second group underwent six manual physical therapy sessionsof 20 min/day applied between sessions. All patients were treated as outpatients and followed in accordance with a protocol approved by the Human Subjects Committee of the University of Michigan. The primary study objective was to determine whether a subacromial corticosteroid injection of 40 mg/day of triamcinolone acetonide would result in sustained improvement in patient fatigue over the course of 12 weeks; secondary studies were conducted to assess the efficacy of subacromial corticosteroid injections of higher doses in addition to the 40 mg dose. Results Outpatients The majority of patients experienced modest decreases in fatigue intensity and the number of physical symptoms, all of which were considered acceptable after 12 weeks. Subacromial Corticosteroid in an Outpatients Population The results from a subacromial steroid injection group comparing 35-week placebo and 40-mg per day group (a total of 454 patients in total) are presented in table 5. At the conclusion of each 12-week cycle, patients in the active subacomplex were treated with a 40-mg subacomplex injection twice weekly to enhance the response of the corticosteroid. In a comparison of the mean scores for fatigue rating, the primary outcome measure, both groups were significantly improved over baseline. TABLE 5 Active vs Control Group Time (wk) %Change, mean score after 12 weeks Placebo 40 mg subacomplex subacomplex Placebo 40 mg subacomplex subacomplex Placebo Mean difference P Value Placebo 40 mg subacomplex subacomplex Placebo 40 mg subacomplex subacomplex Placebo 40 mg subacomplex subacomplex Placebo 40 mg subacomplex subacomplex Active 3.13 (0.51) 3.46 (0.58) 0.0308 0.0516 0.0307 (0.11) 0.0047 <0.0001 0.0019 2.20 (1.20) 20.4 (1.19) 0.0030 0.0303 (0.18) 0.0017 0.0183 0.0046 Active — 0.12 (0.16) — 0.15 0.15 (0.16) — 0.12 (0.05) Active 0.14 (0.27) — 0.22 0.22 (0.28) Related Article: