This is a prospective case–control study comparing short- and medium-term outcomes between sub-acromial and gleno-humeral corticosteroid injections in adhesive capsulitis.
The study population consisted of 105 patients (33 males, 72 females; mean age, 56.1 years). They were divided into three groups: (1) patients receiving 40 mg of methylprednisolone acetate as intra-articular injection (n = 35) followed by physical therapy; (2) patients receiving 40 mg of methylprednisolone acetate as sub-acromial injection (n = 35) followed by physical therapy; (3) patients receiving only physical therapy (heat, passive stretching exercises and wall climbing) and no injections (n = 35). Functional outcome scores (Constant shoulder score and Shoulder Pain and Disability Index), visual analogue scale for pain and range of motion of shoulder joint were noted at 3, 6 and 12 weeks and 6 months.
There was a statistically significant improvement in VAS scores in group 1 and 2 at 3, 6, 12 weeks and 6 months compared to that before the injections. There was no statistically significant improvement in the group 3 at 3 and 6 weeks, but improvement was noticed at 12 weeks and 6 months. There was no statistically significant difference in VAS, CS score, SPADI and ROM between groups 1 and 2 at 3, 6, 12 weeks and 6 months. These scores were significantly better in group 1 and 2 compared to group 3 at 3, 6, 12, weeks and 6 months.
Corticosteroid injections into the sub-acromial space and into the gleno-humeral joint produce similar results in terms of pain relief and improvement in function in patients with adhesive capsulitis.
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Lundberg BJ (1969) The frozen shoulder. Acta Orthop Scand 119:1–59
Hong JY, Yoon SH, Moon DJ, Kwack KS, Joen B, Lee HY (2011) Comparison of high- and low-dose corticosteroid in subacromial injection for periarticular shoulder disorder: a randomized, triple-blind, placebo-controlled trial. Arch Phys Med Rehabil 92:1951–1960
Buchbinder R, Green S, Youd J (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 89:CD004016
Bloom JE, Rischin A, Johnston RV, Buchbinder R (2012) Image-guided versus blind glucocorticoid injection for shoulder pain. Cochrane Database Syst Rev 15(8):CD009147
Sethi PM, Kingston S, Elattrache N (2005) Accuracy of anterior intraarticular injection of the glenohumeral joint. Arthroscopy 21:77–80
Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP (2011) Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg 20:1034–1040
Rizk TE, Pinals RS, Talaiver AS (1991) Corticosteroid injections in adhesive capsulitis: investigation of their value and site. Arch Phys Med Rehabil 72:20–22
Shin SJ, Lee SY (2013) Efficacies of corticosteroid injection at different sites of the shoulder for the treatment of adhesive capsulitis. J Shoulder Elbow Surg 22(4):521–527
Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94:149–158
Kim KC, Rhee KJ, Shin HD (2009) Adhesive capsulitis of the shoulder: dimensions of the rotator interval measured with magnetic resonance arthrography. J Shoulder Elbow Surg 18:437–442
Neer CS, Satterlee CC, Dalsey RM, Flatow EL (1992) The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res. 280:182–185
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The authors declare that they have no conflict of interests.
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Goyal, T., Singh, A., Negi, P. et al. Comparative functional outcomes of patients with adhesive capsulitis receiving intra-articular versus sub-acromial steroid injections: case–control study. Musculoskelet Surg 103, 31–35 (2019). https://doi.org/10.1007/s12306-018-0538-8