La terapia infiltrativa locale nelle affezioni dolorose della spalla

Shoulder pain may be seen in association with many medical conditions. Specific examination techniques, inspection, palpation and mobilization of the shoulder is important to localize the source of pain. Management of the painful shoulder is difficult; with this terminology we describe a wide number of pathological diagnoses that often have a common aetiology: the damage of the rotator cuff mechanism. When there is a failure of initial treatment with rest and oral non steroidal inflammatory drugs, only intraarticular injections are able to improve pain and range of movement. Many therapies have been tried: intraarticular corticosteroids, antiflammatory agents, anaesthetics, orgotein, somatostatine, hyaluronic acid and physiotherapy, are the more common methods of treatment. Unfortunately not all the studies have an appropriate methodology, so the best form of drug therapy is still controversial.