Idiopathic frozen shoulder (adhesive capsulitis) is a common and debilitating condition, characterized by progressive restriction of shoulder movement. Non-randomized interventional treatments, such as intraarticular corticosteroid injections and hydrostatic (hydrodilatation) distention, are commonly employed when conservative therapy fails.
Muhammad Anas Ghazi et al conducted a study to compare the short-term effectiveness of intra-articular corticosteroid injection versus hydrostatic distention, in terms of pain relief and functional improvement in patients with idiopathic frozen shoulder.
A total of 108 patients, aged 35-70 years, with frozen-phase idiopathic frozen shoulder (>3 months’ duration), were assigned to two treatment groups using non-random, consecutive allocation: Group A (n = 54) received an intra-articular corticosteroid injection, and Group B (n = 54) underwent hydrostatic shoulder distention. Patients were assessed at baseline, 4 weeks, and 12 weeks using the Visual Analog Scale (VAS) for pain and the Shoulder Pain and Disability Index (SPADI) for function.
Key findings of the study were:
• Both groups showed significant improvements in pain and function over time (p < 0.001).
• Group A demonstrated superior outcomes at 12 weeks in VAS (2.1 ± 0.9 vs. 2.6 ± 1.0; p = 0.027) and SPADI (28.6 ± 6.3 vs. 32.9 ± 6.5; p = 0.006).
• “Very satisfied” patients were more frequent in Group A (28 patients; 64.81%) than in Group B (35 patients; 51.85%).
The authors concluded – “In summary, this research shows that, for individuals with idiopathic frozen shoulder, intra-articular corticosteroid injections are superior to hydrostatic shoulder distention in terms of reducing pain and enhancing shoulder function. The data show that the corticosteroid injection group experienced better levels of pain relief, functional improvement, and patient satisfaction. In the short term, corticosteroid injections appear to provide more rapid and longer-lasting effects, even though both therapies are effective. Further evaluation of the long-term safety and effectiveness of these therapies in a broader and more diverse population will require additional studies with multicenter data and longer follow-up.”
Further reading:
Short-Term Comparative Effectiveness of Intraarticular Corticosteroid Injection Versus Hydrostatic Distention in Idiopathic Frozen Shoulder: A Prospective Interventional Study
Muhammad Anas Ghazi et al
Cureus 17(6): e86639. DOI 10.7759/cureus.86639
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