FROZEN SHOULDER: OUTCOME OF INTRA-ARTICULAR STEROID INJECTION IN IDIOPATHIC ADHESIVE CAPSULITIS IN TERMS OF PAIN RELIEF AND RANGE OF MOTION
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Objective: To find out the outcomes of intra articular steroid injection in idiopathic adhesive capsulitis, in terms of pain control and functional activity.
Methodology: This Quasi experimental study was conducted in the Department of Orthopedic and Spine, Hayatabad Medical Complex, from February 2019 to February 2020. All patients aged above 18 years of age, both genders, having a diagnosis of idiopathic adhesive capsulitis were included in this study. A total of 200 patients were included in the study. Sample size was calculated by Open-Epi. Their pre injection Shoulder Pain and Disability Index (SPADI) and Visual Analogue Score (VAS) were recorded. All patients received intra-articular corticosteroid injection. SPADI and VAS were recorded after 4 and 12 weeks. The baseline scores and those recorded at follow up after injection were compared. Data was analyzed using SPSS version 23.
Results: Out of 200, 86 (43%) were female and 114 (57%) were male. The average age of our patients was 50.85 (±7.36). Their average pre injection SPADI was 79 (±6.4) while the average VAS was 6.5 (±0.9). Mean evaluation scores at 4th week of intra-articular corticosteroid injections were improved to SPADI 27.32 (±3.14) and VAS was 2.55 (±1.1) with a statistically significant p-value of 0.0001. At 12th week SPADI disability score was still consistent at 27 (±3) but their VAS score worsened to 6.1 (±0.86).
Conclusion: Patients suffering from idiopathic adhesive capsulitis can benefit from intra-articular corticosteroid injection alone. The range of motion and functional ability in their diseased shoulder can get better till 12 weeks. Their pain, on other hand, will get better initially but later on it’ll re-appear and would warrant re-evaluation and change in management plan.
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Shang X, Zhang Z, Pan X, Li J, Li Q. Intra-articular versus subacromial cor¬ticosteroid injection for the treatment of adhesive capsulitis: A meta-analysis and systematic review. BioMed Res Int. 2019; 15: 2019.
Cho CH, Bae KC, Kim DH. Treatment Strategy for Frozen Shoulder. Clin Or¬thop Surg. 2019;11(3):249-57.
Sharma SP, Bærheim A, Moe-Nilssen R, Kvåle A. Adhesive capsulitis of the shoulder, treatment with corticoste¬roid, corticosteroid with distension or treatment-as-usual; a randomised con¬trolled trial in primary care. BMC Mus¬culoskelet Disord. 2016;17:232.
Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of ran¬domised trials using multiple corti¬costeroid injections. Br J Gen Pract. 2007;57(541):662-7.
Wiley AM. Arthroscopic appearance of frozen shoulder. J Arth Rel Sur. 1991;7(2):138-43.
Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Sho Elb Sur. 2011;20(3):502-14.
Hannafin JA, Chiaia TA. Adhesive cap¬sulitis. A treatment approach. Clin Orth Rel Res. 2000; (372):95-109.
Favejee M, Huisstede B, Koes B. Frozen shoulder: the effectiveness of conser¬vative and surgical interventions— systematic review. Br J Spo Med. 2011;45(1):49-56.
Reeves B. The natural history of the fro¬zen shoulder syndrome. Scan J Rheu. 1975; 4(4):193-6.
Song A, Higgins LD, Newman J, Jain NB. Glenohumeral corticosteroid in¬jections in adhesive capsulitis: a sys¬tematic search and review. PM & R. 2014;6(12):1143-56.
D’Orsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a re¬view. Mus Lig Tend J 2012;2(2):70-8.
Buchbinder R, Green S, Youd JM. Cor¬ticosteroid injections for shoulder pain. Coch Data Sys Rev. 2003(1).
Griesser MJ, Harris JD, Campbell JE, Jones GL. Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular cor¬ticosteroid injections. JBJS. 2011; 93(18):1727-33.
Wang W, Shi M, Zhou C, Shi Z, Cai X, Lin T, et al. Effectiveness of cortico¬steroid injections in adhesive capsuli¬tis of shoulder: A meta-analysis. Med. 2017;96(28):7529.
Tveitå EK, Tariq R, Sesseng S, Juel NG, Bautz-Holter E. Hydrodilatation, corti¬costeroids and adhesive capsulitis: A randomized controlled trial. BMC Mus Disord. 2008;9(1):53.
Siraj M, Anwar W, Iqbal MJ. Effective¬ness of intra-articular corticosteroid injection in the treatment of idio¬pathic frozen shoulder. J Surg Pak. 2012;17:57-60.
Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bon Joint Surg Am. 1992;74(5):738-46.
Tasto JP and Elias DW. Adhesive capsuli¬tis. Spo Med Arth Rev. 2007;15(4):216- 21.
Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoul¬der): a randomised, double blind, pla¬cebo controlled trial. Ann Rheum Dis. 2004;63(11):1460-9.