Faster and Superior Functional Recovery and Sleep Quality with Steroid Injection Versus Physical Therapy for Partial-Thickness Supraspinatus Tendon Rupture.
Bayrak A, Kantarcı M, et al. • Clinics in orthopedic surgery • 2026
Both steroid injection and physical therapy improved functional results and sleep quality in partial-thickness supraspinatus tendon rupture, but the steroid injection group demonstrated earlier and greater improvement in sleep quality while functional outcomes were similar between groups.
Key Findings
Results
Both steroid injection and physical therapy significantly improved QuickDASH functional scores from baseline to 1 month after the procedure.
SI group showed significant improvement in QuickDASH from baseline to 1 month (p = 0.001)
PTR group showed significant improvement in QuickDASH from baseline to 1 month (p = 0.011)
SI group had 22 patients; PTR group had 25 patients
Functional outcome measure was the Short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire
Results
Both steroid injection and physical therapy significantly improved QuickDASH functional scores from baseline to 3 months after the procedure.
SI group showed significant improvement in QuickDASH from baseline to 3 months (p = 0.001)
PTR group showed significant improvement in QuickDASH from baseline to 3 months (p = 0.033)
There was no statistically significant difference between QuickDASH scores at any timepoint when comparing the two groups directly
Results
Both steroid injection and physical therapy significantly improved Pittsburgh Sleep Quality Index (PSQI) scores from baseline to 1 month after the procedure.
SI group showed significant improvement in PSQI from baseline to 1 month (p = 0.001)
PTR group showed significant improvement in PSQI from baseline to 1 month (p = 0.001)
Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI)
Results
Both steroid injection and physical therapy significantly improved PSQI sleep quality scores from baseline to 3 months after the procedure.
SI group showed significant improvement in PSQI from baseline to 3 months (p = 0.001)
PTR group showed significant improvement in PSQI from baseline to 3 months (p = 0.001)
Results
PSQI sleep quality scores were significantly lower (better) in the steroid injection group compared to the physical therapy group at both 1 month and 3 months after the procedure.
PSQI scores in the SI group were significantly lower at 1 month after the procedure (p = 0.001)
PSQI scores in the SI group were significantly lower at 3 months after the procedure (p = 0.006)
This indicates earlier and greater improvement in sleep quality in the SI group compared to PTR group
Results
There was no statistically significant difference in functional outcomes (QuickDASH scores) between the steroid injection and physical therapy groups at any timepoint.
QuickDASH scores were compared between groups at baseline, 1 month, and 3 months
No statistically significant between-group difference was found at any timepoint
Both groups achieved similar functional recovery despite different treatment modalities
Methods
The steroid injection treatment consisted of 1 mL betamethasone combined with 9 mL prilocaine, while physical therapy consisted of deltoid muscle exercise.
SI group received 1 mL betamethasone + 9 mL prilocaine injection
PTR group was treated with deltoid muscle exercise
Outcomes were evaluated at baseline, 1 month, and 3 months after the procedure
Diagnosis of partial-thickness supraspinatus tendon rupture (PTSR) was required for inclusion in the study
What This Means
This research compared two common treatments for partial-thickness tears of the supraspinatus tendon (a rotator cuff tendon in the shoulder): a corticosteroid injection (betamethasone mixed with a local anesthetic) versus a physical therapy program focused on deltoid muscle exercises. The study included 47 patients total — 22 in the injection group and 25 in the physical therapy group — and tracked both arm/shoulder function and sleep quality at the start of treatment, at one month, and at three months.
Both treatments led to meaningful improvements in shoulder function and sleep quality over the three-month study period. However, patients who received the steroid injection reported significantly better sleep quality at both the one-month and three-month checkpoints compared to those who did physical therapy. In contrast, shoulder function scores improved similarly in both groups, with no meaningful difference between them at any time point.
This research suggests that for people with partial-thickness supraspinatus tears, both steroid injections and physical therapy can improve how well the shoulder works and how well patients sleep. However, steroid injections may offer a faster and more pronounced benefit for sleep quality, which can be an important quality-of-life concern for shoulder pain sufferers. The similarity in functional outcomes means that the choice of treatment may depend on individual patient factors such as sleep disturbance severity, preference for injection versus exercise-based therapy, and the potential side effects of each approach.
Bayrak A, Kantarcı M, Özönder F, Aydeniz B, Altun T, Basaran S. (2026). Faster and Superior Functional Recovery and Sleep Quality with Steroid Injection Versus Physical Therapy for Partial-Thickness Supraspinatus Tendon Rupture.. Clinics in orthopedic surgery. https://doi.org/10.4055/cios25031