Skip to main content
SpringerLink
Log in

Comparative functional outcomes of patients with adhesive capsulitis receiving intra-articular versus sub-acromial steroid injections: case–control study

MUSCULOSKELETAL SURGERY volume 103, pages 31–35 (2019)Cite this article

Abstract

Purpose

This is a prospective case–control study comparing short- and medium-term outcomes between sub-acromial and gleno-humeral corticosteroid injections in adhesive capsulitis.

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Lundberg BJ (1969) The frozen shoulder. Acta Orthop Scand 119:1–59

    Article  CAS  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. Buchbinder R, Green S, Youd J (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 89:CD004016

    Google Scholar 

  4. 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

    Google Scholar 

  5. Sethi PM, Kingston S, Elattrache N (2005) Accuracy of anterior intraarticular injection of the glenohumeral joint. Arthroscopy 21:77–80

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    CAS  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  CAS  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Virbhadra Marg, Rishikesh, 248201, India

    T. Goyal, A. Singh, P. Negi & B. Kharkwal

Authors
  1. T. Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Negi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Kharkwal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Goyal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-018-0538-8

Keywords

search

Navigation