Addition of Lidocaine Injection Immediately before Physiotherapy for Frozen Shoulder: A Randomized Controlled Trial

Hsu, Wei‐Chun; Wang, Tao-Liang; Lin, Yi‐Ying; Hsieh, Lin‐Fen; Tsai, Chun-Mei; Huang, Hui‐Kuang

doi:10.1371/journal.pone.0118217

Cited by 15 publications

(17 citation statements)

References 33 publications

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“…Statistically significant differences were noted between two groups in terms of pain relief as reported earlier by Wei-Chun 20 Hsu et al . Similarly, the difference in ease of performing ADL between two groups was statistically significant, patients in Group A performing better.…”

Section: Original Article a Comparative Study Of Steroid Injection Wisupporting

confidence: 71%

“…The intra-articular injection of lignocaine immediately before a physiotherapy session may relieve pain during the stretching and mobilization of the affected joint in patients with a frozen shoulder, thus enhancing the treatment effect. As physical therapy (Physiotherapy) is the prime factor for its treatment, immediate pain relief is a major determinant for the patients to 20 follow it . The early the start of physical therapy, the sooner and better is the outcome.…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

Pandey

Shrestha

2018

J Univ Coll Med Sci

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BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B. In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28

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Section: Original Article a Comparative Study Of Steroid Injection Wisupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

Pandey

Shrestha

2018

J Univ Coll Med Sci

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“…Strengthening of the rotator cuff muscles was performed by means of isometric and isotonic exercises with the use of a theraband and dumbbells and was combined with TENS and mobilization in the study by Rawat et al Moreover, the addition of supervised physiotherapy 359 including mobilization and stretching to a home exer-360 cise program had no significant effect in improving the 361 clinical outcomes compared to home exercises alone 362 in patients after the hydrodilatation procedure at one 363 year follow up [60]. Hsu et al [50] showed that the 364 introduction of 3 ml of 1% lidocaine injection prior 365 to physiotherapy was effective in relieving pain dur-366 ing stretching and mobilization and thereby improved 367 outcomes at six months follow up. Jellad et al [64] 368 introduced intra-articular distension (IAD) before and 369 after physiotherapy sessions to compare with the phys-370 iotherapy alone group for 12 weeks.…”

Section: Quality Reviewmentioning

confidence: 99%

The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review

Nakandala

Nanayakkara

Wadugodapitiya

et al. 2021

BMR

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BACKGROUND: Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various non-operative methods has been demonstrated to improve the pain, range of motion (ROM) and functional status of patients with adhesive capsulitis. OBJECTIVE: This study aims to review recent evidence on the efficacy of physiotherapy interventions in the treatment of adhesive capsulitis. METHODS: PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and Cochrane databases were searched for studies published since 2013. The search terms included: Frozen shoulder, adhesive capsulitis, physical therapy, rehabilitation, manual therapy, mobilization, exercise, education, and electrotherapy. The search was limited to studies published in English and studies that used human subjects. RESULTS: Quality scores of 33 articles were reviewed according to the Sackett’s critical appraisal criteria and the grades of recommendation were determined for physiotherapy interventions used in the studies. CONCLUSION: The empirical evidence suggests that certain physical therapy techniques and modalities are strongly recommended for pain relief, improvement of ROM, and functional status in patients with adhesive capsulitis, while others are either moderately or mildly recommended. However, the efficacy of one treatment modality over another is uncertain. The poor methodological rigors demonstrated in most of the reviewed studies emphasize the urgent need of properly conducted, adequately sampled randomized controlled trials with adequate follow up to determine the superior combination of treatment.

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“…Chen et al showed that text messages sent to patients by mobile phone to remind and encourage them significantly increased compliance with their own exercises and thus improved the mobility of the shoulder [22]. An intra-articular injection of lidocaine immediately before physiotherapy to improve patient compliance was also shown to be superior to pure physiotherapy in the treatment of shoulder stiffness [23]. However, the negative effects of local anaesthetics on cartilage should be taken into account when this procedure is performed [24].…”

Section: Physiotherapymentioning

confidence: 99%

Shoulder Stiffness – How to Treat?

et al. 2019

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Shoulder stiffness is a condition of restricted glenohumeral range of motion, which can arise spontaneously or as consequence of a known cause, including surgical procedures on the shoulder. Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. The aim of this review was to summarize the current concepts on conservative and operative treatment of shoulder stiffness and discuss the results of the available studies with a high level of evidence, which should be considered to guide clinical practice. Treatment of shoulder stiffness should be tailored to the patientʼs clinical situation and the stage of its shoulder pathology and should aim at pain reduction, restoration of range of motion, functional regain and shortening of symptoms duration. When possible, known risk factors for primary shoulder stiffness and causes of secondary shoulder stiffness should be addressed to avoid relapse. Conservative therapy is the mainstay of treatment for shoulder stiffness and should include a multimodal and activity-oriented program. Intra-articular injection of a low dose of corticosteroid is safe and effective, provides immediate benefits, and is recommended in combination to an appropriate rehabilitation protocol. In conservative refractory cases, arthrolysis and capsular release can be performed with an arthroscopic approach.

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Addition of Lidocaine Injection Immediately before Physiotherapy for Frozen Shoulder: A Randomized Controlled Trial

Cited by 15 publications

References 33 publications

A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review

Shoulder Stiffness – How to Treat?

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