This cohort study aimed to investigate the association between steroid injections for shoulder diseases and the increased incidence of cuff tendon tears. The Kaohsiung Veterans General Hospital clinical database was used in this study. Patients were enrolled using the corresponding diagnostic codes for shoulder diseases. Patients who received steroid injections were included in the case group, and those without steroid injections were included in the control group. The outcome measure was the occurrence of cuff tendon tears during the study period. Adjusted hazard ratios for outcomes were calculated using Cox regression analysis adjusted for sex, age, and comorbidities. Of the 1025 patients with shoulder disease, 205 were in the case group and 820 were in the control group. The incidence of cuff tendon tears was 9.8% in patients who received steroid injections (p < 0.001). The adjusted hazard ratios for steroid injections, smoking, and chronic liver disease were 7.44 (p < 0.001), 2.40 (p = 0.046), 3.25 (p = 0.007), respectively. Steroid injections on the shoulder were associated with a raised risk of cuff tendon tears by 7.44 times compared to non-injection. The incidence of cuff tendon tears increased by 3.25 times with concurrent chronic liver disease and by 2.4 times with smoking.
To investigate the effectiveness of health promotion strategies for nonspecific low back pain in hospital workers, we compared the therapeutic effects of group-based core stability exercises and an educational booklet. Subjects participated in a 60-min core stability exercise on a weekly basis for 8 weeks (N = 24) or consulted an educational booklet for advice (N = 22). The numerical rating scale (NRS), Oswestry Disability Index (ODI), and the brief version of the World Health Organization’s Quality of Life (WHOQOL-BREF) were used as outcome measures. The ODI, as well as the total score and domains of overall, physical, and psychological health in the WHOQOL-BREF were significantly improved in the exercise group (p < 0.05). The NRS score significantly improved in the booklet group (p < 0.05). The total score, psychological domain, and environmental domain of the WHOQOL-BREF improved significantly in the exercise group compared with the booklet group (p < 0.05). Group-based core stability exercises and educational booklets are helpful to hospital workers in different ways for nonspecific low back pain. In contrast to the pain reduction by the educational booklet, more active participation in group-based core stability exercise can provide a better outcome in the overall quality of life, especially in the psychological and environmental domains of hospital workers.