Is there a short-term benefit from an intra-articular steroid injection in female patients with adhesive capsulitis of the shoulder treated with physiotherapy?

Abstract

Introduction: The purpose of this retrospective study was to investigate the possible short-term benefit of a single intraarticular corticosteroid injection in those patients treated with physiotherapy when compared to a group of patients undergoing physiotherapy only (PT only). Methods: A retrospective chart review was conducted to identify eligible patients treated over a 4-year period. All female patients between 40 years and 60 years with a confirmed clinical diagnosis of idiopathic adhesive capsulitis who completed a prescribed physiotherapy program were considered eligible. Sixty-three patients fulfilled the inclusion criteria, but 22 were excluded because of missing data in the medical record. The remaining 41 patients comprise the study cohort; an experienced musculoskeletal physiotherapist assessed these patients both at initial presentation and at 12 weeks. Twenty patients with a mean age of 55.1 years underwent PT only and 21 patients with a mean age of 52.4 years received a single intra-articular dose of 40 mg methylprednisolone followed by physiotherapy. Outcome measures included the visual analogue scale (VAS) and measurement of range of motion. Results: At final assessment (12 weeks), significant between-group differences were identified for the 'PT only' group for flexion (p ¼ 0.01) and abduction (p ¼ 0.008). When comparing the mean change from the initial assessment, a significant between-group difference was observed for abduction (p ¼ 0.03). Conclusions: The results of this study suggest that the intra-articular injection of a single dose of cortisone has no significant short-term benefit in female patients with idiopathic adhesive capsulitis managed with physiotherapy.

Effectiveness of Intra-articular Steroid Injection in Treatment of Idiopathic Frozen Shoulder Followed by Physiotherapy and Home Exercise Program.

“…Various studies shows intra-ar cular steroid with physiotherapy have be er 15 outcomes. Physiotherapist instructs the pa ent with the standardized home exercise and encourages performing these three mes each day and all pa ents were encouraged 16 to con nue performing their usual ac vi es of daily living. Supervised physiotherapy in intra-ar cular injec on 15 provides faster improvement in shoulder ROM.…”

Physiotherapy, Local Acupuncture, and Auricular Acupuncture for Frozen Shoulder

“…2 Effects of corticosteroids have been investigated previously in some studies; however, benefits are balanced, with adverse effects especially in women. 2,19 Therapeutic plans for frozen shoulder are still not perfect and further research is required to investigate more successful treatment programs. 2 Moreover, clinicians are constantly confronted with new technological tools of uncertain clinical importance such as ultrasonic therapy, transcutaneous electrical nerve stimulation, short-wave therapy, and low-level laser therapy, 2,20 among others.…”

“…Side effects of analgesic medications are still challenging, and desirable effects of nonsteroidal anti-inflammatory drugs on joint movement are not established yet 2. Effects of corticosteroids have been investigated previously in some studies; however, benefits are balanced, with adverse effects especially in women 2,19…”