Intra-articular corticosteroid injection for the treatment of idiopathic adhesive capsulitis of the shoulder

Abstract

Treatment for idiopathic adhesive capsulitis or frozen shoulder of the shoulder is controversial. The hypothesis of the study is that intra-articular corticosteroid injection in the early stages of idiopathic adhesive capsulitis will lead to a rapid resolution of stiffness and symptoms. This is a prosspective cohort study of only patients with stage 1 or stage 2 adhesivecapsulitis. The diagnosis was made by history and physical examination and excluding other causes of shoulder pain and loss of motion. Stage 1 adhesive capsulitis was defined as patients with significant improvement in pain and range normalization of motion following intraarticular injection. Stage 2 included patients who had significant improvement in pain and partial improvement in range of motion following intra articular injection. 7 patients with stage 1 and 23 patients with stage 2 comprised the baseline cohort. The mean age was 59 years (range: 42 to 72); 8 patients were female and 22 patients had diabetes mellitus. All patients completed physical examination and shoulder rating questionnaire for symptoms and disability. Criteria for resolution were defined as forward flexion and external rotation to within 150 of the contralateral side and internal rotation to within three spinal levels of the contralateral side.