In patients with impingement syndrome of the shoulder, is physical therapy superior to subacromial corticosteroid injection?

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Physical therapy (PT) and corticosteroid injections are likely equivalent in decreasing pain and improving function in patients with impingement syndrome at 6 months although corticosteroids may be more effective in the first few months (SOR: B, systematic review of low-quality RCTs). Exercise therapy is generally recommended first, but steroid injection may be considered for severe symptoms in the first 8 weeks (SOR: C, expert opinion).

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