The aim of this clinical trial is to determine whether point-of-care ultrasound-guided corticosteroid injection is more effective than conventional injection guided by anatomical landmarks or standard oral medication for patients with upper-extremity conditions (subacromial impingement syndrome \[SAS\] or carpal tunnel syndrome \[CTS\]) in primary care.
The main questions this study seeks to answer are:
Does ultrasound-guided injection provide superior long-term pain relief compared to blind anatomical injection and oral medication?
Does ultrasound-guided injection lead to better functional recovery and improved health-related quality of life in patients?
Is ultrasound-guided injection a cost-effective strategy from both the healthcare system and societal perspectives (including reducing sick leave)?
This study represents the quantitative phase of the mixed-methods Q-EPICAP study. Researchers will compare three parallel groups across 23 primary care centers to determine the most effective and efficient treatment strategy.
Participants will:
Receive one of three assigned treatments: blind anatomical infiltration (Group I), ultrasound-guided infiltration (Group UI), or standard oral drug therapy (Group P).
Attend follow-up assessments at baseline and at 15, 30, 90, and 180 days after the initial intervention.
Complete questionnaires to assess pain intensity (Visual Analog Scale), upper limb function (ASES or Boston Disability Assessment Questionnaire), and quality of life (EQ-5D-5L).
Provide data on medical resource utilization and sick leave to assess socioeconomic costs.