Ömer Faruk Bucak, Emine Cengiz Çavu şoğlu, Adil Öncel, Eser Kalao ğlu
The European Research Journal - 2025;11(6):1057-1066
Objectives: To investigate whether somatosensory amplification - a heightened sensitivity to normal bodily sensations - affects the clinical response to corticosteroid injection in shoulder impingement syndrome (SIS) patients who did not respond to conservative treatment. Methods: This prospective observational study included 70 patients with SIS and persistent pain despite at least four weeks of physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). All patients received a standardized corticosteroid injection into the subacromial space under ultrasound guidance. Pain intensity was measured using the Visual Analog Scale (V AS) at rest (V AS-rest) and during movement (V AS-movement), while shoulder-related disability was assessed with the Shoulder Pain and Disability Index (SPADI) at baseline and one month after the injection. Somatosensory amplification - referring to increased sensitivity to normal bodily sensations-was evaluated using the Somatosensory Amplification Scale (SSAS), a brief self-report questionnaire administered at the one-month follow-up by a psychiatrist blinded to clinical outcomes. Treatment response was defined as a >=30% reduction in V AS-movement, based on the minimal clinically important difference (MCID). Patients were categorized as responders or non-responders accordingly. Results: Thirty (42.9%) patients were classified as responders and 40 (57.1%) as non-responders. At 1-month, non-responders had significantly higher SSAS scores than responders (30.7 [27.4-32.6] vs. 21.5 [19.4-23.4], P<0.001). Compared to non-responders, the responder group demonstrated more significant improvements in V AS-rest, V AS-movement, and SPADI scores (P<0.001 for all). Spearman correlation analysis revealed strong positive correlations between SAS and V AS-rest (r=0.732), V AS-movement (r=0.748), and SPADI (r=0.734); P<0.001 for all. Conclusions: Higher levels of somatosensory amplification were linked to a lower likelihood of benefiting from subacromial injection in SIS. These findings support the importance of including psychosomatic assessment in routine care to improve treatment outcomes and guide more personalized management.
