Subacromial Injection With Corticosteroid Versus Nonsteroidal Anti-inflammatory Drugs (NSAID) in Shoulder Impingement Syndrome

Inclusion Criteria: 1. Shoulder pain characteristic of subacromial impingement syndrome with passive and/or active abduction in the 60-120 arc of motion (positive impingement sign) 2. Diagnosis of subacromial bursitis based on tenderness to palpation anterior/lateral to the acromion. Pain may be exacerbated with the shoulder held in internal rotation (positive Hawkins test) Exclusion Criteria: 1. Age \<18 years 2. Symptoms less than one month 3. Previous shoulder injections within the past 3 months 4. Evidence of os-acromiale or other confounding shoulder pathology on plain radiographs 5. Evidence of shoulder osteoarthritis 6. Full thickness rotator cuff tear evidenced by MRI, cuff weakness after lidocaine injection, or positive drop-arm sign 7. Systemic inflammatory condition 8. Pending litigation or work-related claims related to the shoulder 9. Previous shoulder surgery on the affected shoulder 10. Evidence of local infection 11. Evidence of adhesive capsulitis 12. Previous history of gastrointestinal ulcers or bleeding disorders 13. Evidence of shoulder instability