Clinical inquiries. Does injection of steroids and lidocaine in the shoulder relieve bursitis?

■ EVIDENCE-BASED ANSWER Subacromial steroid injection may provide a small, short-term benefit compared with placebo. The short-term effectiveness of steroid injection compared with nonsteroidal anti-inflammatory agents (NSAIDs) remains unclear. Steroid injections are better than physiotherapy alone in the short term. However, injection does not appear to provide any meaningful longterm benefit compared with other therapies (strength of recommendation: B). Data are insufficient to make recommendations regarding the proper timing of injection in the sequence of other treatments. Side effects of steroid injection, such as steroid flare and infection, are rare.