OBJECTIVE: To investigate the effectiveness of a physiotherapy programme in patients with subacromial impingement syndrome. DESIGN: Prospective randomised study. SETTING: Orthopaedic department in a district general hospital. PARTICIPANTS: Eighty-five patients who had been listed for surgery for subacromial impingement syndrome. INTERVENTIONS: Patients were allocated at random into one of two groups. One group containing 45 patients received physiotherapy while the other group containing 40 patients acted as controls. OUTCOME MEASURES: All patients entering the study underwent Constant score evaluation prior to being allocated to a group. This was repeated at 6 months, prior to surgical intervention. RESULTS: Seventy-three patients were able to complete the study. In the physiotherapy group, 11 patients no longer required surgery (26%). In this group, all patients improved their Constant score by a mean of 20 (range 4 to 45). In the control group, all patients required surgery. The mean improvement in the Constant score for the 31 control patients available for review was 0.65 (range 16 to 14). CONCLUSION: All patients in this study improved with physiotherapy. Physiotherapy should be thought of as a first-line management for patients with subacromial impingement syndrome.

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