Physical therapy and hyaluronic acid (HA) injections have both been shown to be effective in reducing pain with shoulder tendinopathies (injuries to the rotator cuff). However, it has been theorized that combining the two treatments could lead to potential additive effects, although it is currently unproven. A study recently published by a group of researchers from Spain in the Orthopaedic Journal of Sports Medicine, investigated the efficacy and safety of HA injections in conjunction with physical therapy for patients with supraspinatus tendinopathy.
To determine if there was an improved difference, researchers randomly divided 84 patients with ultrasound-confirmed supraspinatus tendinopathy into two groups: one that would receive physical therapy with HA injections, and a control group that would receive only physical therapy. The treatment effectiveness was measured using a Visual Analogue Scale (VAS) and an Activities of Daily Living (ADL), among others. Patients followed up with their physician after 90 days.
Overall, the study showed that patients receiving physical therapy alone required more physical therapy sessions to return to pre-injury activity levels, and subsequently required more days to return to pre-injury level. The study concluded that both patients and investigators believed the physical therapy with HA injections were more effective compared to physical therapy alone. Although this study consist of a small sample size, it does highlight the potential benefit of HA injections for supraspinatus tendinopathy, and illustrates the importance of physical therapy in decreasing pain and restoring physical function.