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

Abstract

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, 56.1years). They were divided into three groups: (1) patients receiving 40mg of methylprednisolone acetate as intra-articular injection (n = 35) followed by physical therapy; (2) patients receiving 40mg 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 12weeks and 6months. There was a statistically significant improvement in VAS scores in group 1 and 2 at 3, 6, 12weeks and 6months compared to that before the injections. There was no statistically significant improvement in the group 3 at 3 and 6weeks, but improvement was noticed at 12weeks and 6months. There was no statistically significant difference in VAS, CS score, SPADI and ROM between groups 1 and 2 at 3, 6, 12weeks and 6months. These scores were significantly better in group 1 and 2 compared to group 3 at 3, 6, 12, weeks and 6months. 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.