The Effect of Glenohumeral Joint Injection Prior to Physical Therapy on Treatment Outcomes in Adhesive Capsulitis

Abstract

Objective: The objective of this study was to evaluate whether ultrasound-guided intraarticular (IA) glenohumeral injection applied before physical therapy and exercise therapy program (PTETP) contributes to the treatment outcomes in patients with adhesive capsulitis of the shoulder (ACS). Methods: The medical records of 93 patients diagnosed with ACS who underwent the same physical therapy modalities five sessions per week for three weeks (consisted of superficial heating (infrared), transcutaneous electrical nerve stimulation, and therapeutic ultrasound) and exercise therapy program between October 1, 2019–March 1, 2020 were retrospectively evaluated. A total of 41 patients who met inclusion and exclusion criteria were divided into two groups in terms of injection application. Patients who were applied ultrasound guided IA glenohumeral injections before PTETP were considered “injection patients” (n=19), while other patients were considered “non-injection patients” (n=22). The active and passive range of motion (ROM), severity of pain, and degrees of pain and disability of the affected shoulders were assessed at baseline (day 0) and end of PTETP (day 21). Results: Physical therapy modalities and exercise therapy used in ACS treatment had a positive effect on pain scores, ROM, and disability scores at the end of three weeks. It was determined that ultrasound-guided IA injection prior to this treatment the positive effect on daytime and nighttime pain but did not provide additional benefit on ROM or disability. Conclusion:Ultrasound-guided glenohumeral IA injection therapy before PTETP may be beneficial in ACS patients with predominant symptoms of pain.