MODUS OPERANDI FOR THE TREATMENT OF FROZEN SHOULDER: A NOVEL APPROACH

Abstract

Introduction: Frozen shoulder is a self-limiting condition which can sometimes last for up to 2 years. The objective of this study was to show the result of combined use of oral corticosteroids, vitamin C, analgesics, glycaemic control and physiotherapy (AAROM) and compare the results with intraarticular injection of corticosteroids. Methods: 70 patients aged 28 to 63 years were chosen at the beginning of the study. They had been suffering from frozen shoulder from 2 weeks to 1 year (mean 5.7 months) and 12 patients had diabetes. They were managed with strict glycaemic control and Vit. C tablets twice a day for 1 week along with adequate anti-inflammatory treatment. Out of the 54 patients,18 were given 15 mg Prednisolone BD was given for 2 weeks aided by Vit. C and anti-inflammatory drugs,18 were give oral prednisolone(0.5mg/kg/day) alone and the remaining were treated with intraarticular injections. Physiotherapy was started after 1 week in everyone and continued till pain relief was achieved or till 10 weeks.4 patients were lost to follow up. The ROM, the duration of the pain and the severity of the pain (assessed with VAS and McGill Pain Questionnaire) were the main parameters used. Results: The outcomes of combined therapy for frozen shoulder were better if the patients were subjected to physiotherapy after 1 week of starting oral steroids compared to intraarticular injection/oral use of corticosteroids alone.However, in diabetic patients, the outcomes were better with the use of intraarticular injection of corticosteroids and glycaemic control was required for pain relief and improving ROM.