Intra-articular Steroid Injection Research Articles

Critical Lower-Limb Ischemia and Arterial Thrombosis Following Intraarticular Corticosteroid Injection of the Knee.

We present a case of acute lower-limb arterial thrombosis following intra-articular steroid injection into the knee of a previously fit and active 41-year-old man. Symptoms of acute limb ischemia developed within 24 hours of treatment. Objective assessment with ultrasound arterial duplex and CT angiogram of the lower limb confirmed acute thrombosis of the popliteal artery in the treated leg. Although there is documented evidence of the association between steroid therapy and venous thromboembolic phenomena, there are no cases of arterial thrombosis in the literature. The temporal series of events that we report strongly suggest an association between the corticosteroid injection and the acute thrombotic event, the mechanism of which remains unclear. The patient underwent successful revascularization. It is important to document and disseminate this seemingly rare complication of a commonly associated procedure to increase awareness, invoke caution, and invite others to share similar cases.

Study of Functional Outcome of Intra-articular Steroid Injection and Manipulation of Shoulder Joints in Frozen Shoulder.

Frozen shoulder, also known as adhesive capsulitis, is characterized by the insidious onset of pain and progressive loss of global active and passive mobility of the glenohumeral joint, which can be treated by non-surgical or surgical methods. This study was done to evaluate the functional outcome of intra-articular (I/A) steroid injection and manipulation of the shoulder joint manipulation under anesthesia (MUA) in frozen shoulder. A cross-sectional study was done in a tertiary care hospital in Pokhara, Nepal. A total of 35 patients over 40 years were included in the study. All the patients underwent I/A steroid injection and MUA. The functional outcome was evaluated using a Constant-Murley shoulder score (CSS) and a visual analogue scale (VAS) scoring system. The mean age was 53.46±7.524 years. Twenty-two were female, while 13 were male. Twelve patients were associated with diabetes. Minor complications were noted in 15 patients (14 with transient pain and one with facial flushing). At 12 weeks, the mean VAS score was 2.16±1.33 cm, and the mean CSS score was 82.66±7.008. At 24 weeks, the mean VAS was 1.534±1.195 cm, and the mean CSS score was 85.77±6.998. This study shows that patients with frozen shoulder treated with I/A steroid injection and MUA give excellent functional outcomes in most patients.

Comparison of Pain With Ultrasound-Guided Intra-Articular Hip Injections With and Without Prior Subcutaneous Local Anesthesia.

To compare pain levels of intra-articular hip steroid injections performed with and without prior subcutaneous local anesthesia (LA) injection. Randomized prospective study. University-based musculoskeletal clinic. Forty-one adult patients undergoing a first-time ultrasound-guided unilateral intra-articular hip steroid injection. Subjects were randomized into 1 of 2 groups: intra-articular hip injection with prior subcutaneous LA with 2 mL of lidocaine 1% (With LA) or hip injection without prior subcutaneous LA (Without LA). Visual analog scale (VAS) pain scores (0-100) were collected before and after each injection. Visual analog scale pain score for the intra-articular hip injection. Of the 41 total subjects, 18 were randomized to the Without LA group and 23 to the With LA group. There was no significant difference in baseline (preprocedure) VAS scores between the Without LA (mean ± SD = 39.2 ± 27.2) and With LA (41.2 ± 24.0) groups (P = 0.864). The mean ± SD VAS score for the subcutaneous LA injection in the With LA group was 20.4 ± 16.1. There was no significant difference in VAS scores for the intra-articular hip injection between the Without LA (48.5 ± 27.7) and With LA (39.5 ± 25.7) groups (P = 0.232). Subcutaneous injection of lidocaine before an intra-articular hip injection did not significantly decrease pain from the intra-articular hip injection. Providers may perform intra-articular hip injections with a 22-gauge 3.5-inch spinal needle without the need for an extra subcutaneous LA injection.

A novel methodology utilizing microchip implants to monitor individual activity and body temperature for assessing knee pain in group-housed rats

The pain assessment in animals is challenging as they cannot verbally express the site and severity of pain. In this study, we tried a small implantable actimeter, “Nanotag”, to monitor spontaneous locomotor activity and body temperature in animals suffering from a chemical-induced rat knee arthritis as compared to naïve and steroid-treated rats. Nanotag could detect the decrease in locomotor activity quickly after the arthritis induction and anti-inflammation analgesic treatment by intra-articular injection of steroid significantly improved locomotor activity. These changes were in the same line with those of a conventional knee pain evaluation method (incapacitance test). Nanotag can be utilized as the non-interventional, continuous, and completely objective monitoring the amount of pain in rat knee arthritis model. This traditional yet innovative method may be universally applicable to various pain models and species, making it a worthwhile device for research across diverse fields.

Management of Periarthritis Shoulder by Intra-Articular Steroid Injection and Shoulder Joint Manipulation

Management of Periarthritis Shoulder by Intra-Articular Steroid Injection and Shoulder Joint Manipulation

162 Outcomes Following Surgical Management of Temporomandibular Disorder in a Specialist Setting

Abstract Introduction Temporomandibular joint (TMJ) dysfunction is an increasingly prevalent condition affecting 31% of adults and 11% of children/adolescents. Initial management is usually conservative with physiotherapy, diet modification, analgesics, and education. 5-10% of patients require surgical treatment. TMJ arthroscopies allows minimally invasive surgery for joints with early degenerative changes. The purpose is to provide symptomatic relief and improve function. Aim To evaluate clinical outcomes 3 months post TMJ surgery. Method Retrospective data was collected from the notes of all patients who underwent procedures between February 2019 and August 2023. Data collected included pain/diet scores, mouth opening, Wilkes staging, clinical diagnosis and the use of intra-articular Platelet Rich Plasma or steroid injections. Results 147 procedures were undertaken. The average age was 43 with an 83.0% female predominance. Overall, 1 arthroplasty, 1 eminectomy, 11 total joint replacements and 134 arthroscopies with/without arthrocentesis were performed with positive results. Mouth opening scores increasing from an average of 27.4mm to 29.5mm, diet scores from 5.8 to 7.5 and pain scores reducing from 7.1 to 4.4. At the 3 month follow up, 53 patients were planned for further monitoring, 32 discharged, 9 listed for a further arthroscopy and 15 for a TMJ replacement. Conclusions Surgical management provides good outcomes and Level 2 arthroscopy is an essential tool in the armamentarium. Development of an integrated physiotherapy pathway as well as educational leaflets has been vital. Educational Leaflets improved patient experience with re-audit results showing positive outcomes. Involvement of clinical psychologists is required for a multidisciplinary approach.

Comparison of treatment modalities for Adhesive Capsulitis steroid injection vs Hydrodilatation with steroid injection

Objective: To compare the effectiveness of hydrodilatation with steroids injection versus only steroid injections in the treatment of adhesive capsulitis. Study Design: Prospective comparative study. Place and Duration: This study was conducted at the Department of Orthopaedic Surgery, PAEC General Hospital, Islamabad from 13th Sep 2023 to 12th Feb 2024. Methodology: A total of 54 patients were included in the study. The participants were divided into two groups. Group A participants were given steroid injections only while Group B participants were given steroid injections with hydrodilatation. Pain score was calculated by visual analogue score as 0 being no pain and 10 being the highest degree of pain after injection. Data analysis was done on SPSS version 25.0. Shapiro-Wilk test was performed to analyze whether data follow normal distribution. A p-value ≤0.05 was taken as significant. Results: The Shoulder Pain and Disability Index scores (SPADI) were assessed prior to the intervention, as well as at the two-week, six-week and three-month intervals post-intervention. There was no statistically substantial variation in SPADI scores between the groups two weeks after the injection with p-value of 0.34, however, at 6 weeks (p=0.04) and 3 months (p=0.01) a significant variation in SPADI score was demonstrated with better scores in Group B patients. Conclusion: Our study concluded that the group that received corticosteroids with hydrodilatation showed improved clinical outcomes after six weeks and three months. They also needed less pain medication after the treatment. Consequently, using intra-articular steroid injections with hydrodilatation appears to be a preferable approach for managing adhesive capsulitis during the frozen phase, compared to intra-articular steroid injection alone. Keywords: Adhesive Capsulitis, Corticosteroids, Hydrodilatation, Shoulder Pain and Disability Index, Steroids

Comparison between Intra-Articular Steroid Injection and Supra-Scapular Nerve Block in the Management of Frozen Shoulder.

To compare the efficacy of intra-articular steroid injection with ultrasound-guided supra-scapular nerve block in the management of frozen shoulder in terms of shoulder pain and disability index score and range of motion. This randomized controlled trial was conducted in orthopedic department, PIMS, Islamabad from 1st January, 2020 to 30th June, 2020. A total of 72 patients were randomly equally (n=36 each) allocated to Group-A (intra-articular steroid injection) and Group-B (supra-scapular nerve block). Adults above 18 years of both genders having diffuse shoulder pain were included. Cases of shoulder pain localized because of bicipital tendinitis, rotator cuff tear, pain due to acute trauma and those with osteoarthritis were excluded. Data was analyzed in SPSS version 22.0. Patients average age was 60.1 ± 6.29 in IASI and 58.0 ± 5.83 years in SSNB Group-And there were 19 (52.8%) males in IASI group compared to 15 (41.7%) in SSNB. At three weeks mean pain was significantly less in SSNB (57.1 ± 9.53 vs 49.4 ± 9.02) compared to IASI group (p-value, <0.001). The mean disability index was significantly low in SSNB (51.5 ± 5.10 vs 63.9 ± 5.14) versus IASI group (p-value, <0.001). At one week, three weeks and six weeks, mean external rotation was better in SSNB than IASI group (p-value, <0.001). The mean abduction was also better in SSNB group. Ultrasound guided supra-scapular nerve block is better than intra-articular steroid injection in managing frozen shoulder.

Efficacity of CT-guided intra-articular cervical facet steroid injection for cervical radiculopathy

BackgroundTraditionally, transforaminal steroid injection is performed in the management of cervical radiculopathy in medical failure treatment but carried a true risk of catastrophic complication. Another approach currently used is to perform intra-articular facet steroid injection to reach the epidural space. PurposeThe aim of this study was to describe the evolution of symptoms following intra-articular facet steroid injection in cervical radiculopathy. Material and methodsWe conducted a retrospective study. We assessed all patients who had a CT-guided intra-articular facet steroid injection in our center (xx, xx, xx) from December 2015 to February 2021. Cervical MR pretherapeutic images were analyzed and classified according to cervical pain etiology: uncodiscarthrosis, disk herniation or congestive cervical posterior osteo-arthritis. All patients had clinical initial evaluation and then follow-up at 1 and 6 months. Pain severity was rated on a visual analog scale and expressed as a percentage of improvement. ResultsNinety-three patients were included. There were 56 patients with uncodiscarthrosis, 29 with a disk herniation and 8 with a cervical posterior congestive osteoarthritis. A significant improvement of the visual analog scale percentage was found for all patient at 1 and 6 months (p < 0.01). Visual analog scale percentage improvement was about 50 % for all etiologies. For all patients, no severe complications were reported. ConclusionIntra-articular facet steroid injection may be considered for the treatment of cervical radiculopathy when other medical treatments have failed.

Functional Outcomes of Fluoroscopy-Guided Intra-articular Steroids in Lumbar Facet Arthropathy: A Retrospective Comparative Study of Dexamethasone Versus Triamcinolone Acetonide.

Introduction Mechanical low back pain frequently originates from the lumbar facet joint (LFJ). Axial low back discomfort can result from osteoarthritis in the LFJ. Depending on the severity of LFJ degeneration, the effect of intra-articular (IA) LFJ corticosteroid injection may vary. For LFJ discomfort, IA block with steroids and local anaesthetics has also been utilised, with varying degrees of success. The main objective of this study was to assess the efficacy of IA steroid injections dexamethasone vs. triamcinolone acetonide for the treatment of LFJ syndrome and to compare functional outcome in terms of Visual Analog Scale(VAS) score, Modified Oswestry Disability Index(MODI) score, and short-form McGill Pain Questionnaire between the two groups. Methodology Dexamethasone 8 mg or triamcinolone acetonide 40 mg was given intra-articularly to27 patients comprising group A and 33 patients comprising group B, respectively (total 60 patients). Before intervention and at one, three, and six months, observation was conducted using the VAS score, short-form McGill pain questionnaire, and MODI score. Results There was a significant difference between both the groups after the procedure with pain alleviation and functional improvement, more in the group that received triamcinolone acetonide. A significant difference was observed in all three parameters that assessed pain with differences more pronounced at six months. Conclusion Pain reduction and clinical outcomes were better among the group that received triamcinolone acetonide. Injection of a steroid alone is associated with its own side effects. When a lumbar transforaminal epidural injection is used to treat radiculopathy in the lumbar area, particulate medication (triamcinolone) is more effective than non-particulate medication (dexamethasone) with no known drug-related complications.

Arthro-distension with early and intensive mobilization for shoulder adhesive capsulitis: A randomized controlled trial

BackgroundThere are several therapeutic options for the management of shoulder adhesive capsulitis (AC). The superiority of arthro-distension over intra-articular steroid injection (ISI) for AC remains controversial. ObjectivesTo evaluate the efficacy of a single arthro-distension procedure combined with early and intensive mobilization (ADM) and physiotherapy, versus ISI and physiotherapy, in people with AC lasting ≥3 months. MethodsThis was a prospective, 2 parallel-group, 2-center, observer-blind randomized controlled trial conducted in tertiary care settings. Adults with AC were randomly assigned to the treatment or control group. Efficacy was assessed using the self-administered Shoulder Pain and Disability Index (SPADI). Total, pain and disability SPADI scores 15 days, 6 weeks, and 3, 6 and 12 months after the procedure (total SPADI at 15 days: primary outcome; other outcomes were secondary) were compared between groups using analysis of covariance (ANCOVA). A post hoc analysis stratified on the initial range of passive glenohumeral abduction, which had not been pre-specified, was conducted. ResultsThere were 33 participants in each group. Both groups improved over time. Mean (SD) total SPADI score at 15 days was 33.8 (19.6) in the treatment group and 32.8 (17.5) in the control group, p = 0.393. There were no significant differences for any variables in the overall sample. The post hoc analysis found ADM to be associated with a significant decrease in total SPADI score at 15 days compared with ISI (p = 0.049) in individuals with initial passive glenohumeral abduction >45°. ConclusionsThe effects of ADM on pain and function were not statistically different from those of ISI. However, ADM may be useful in individuals with initial passive glenohumeral abduction >45°. Database registrationNCT00724113.

Intra-articular steroids for the treatment of coxarthrosis; a retrospective cohort study comparing three contrast techniques.

Intra-articular steroid injections (IAS) are a treatment for coxarthrosis. This study examines the efficacy of three fluoroscopy-guided IAS contrast techniques for coxarthrosis: contrast-assisted (Iohexol), air arthrogram-assisted and blind (contrast/air free) and stratifies efficacy based on multiple patient variables. A cohort of 307 hip IAS was retrospectively analysed over a four-year period. The primary outcome was efficacy of IAS between each technique group, defined by duration of symptomatic relief. The secondary outcome was efficacy based on multiple patient variables. Variables included age, BMI, gender, type of osteoarthritis, grade of osteoarthritis, smoking status, co-morbidity index and duration of pre-injection symptoms. Chi-squared, Pearson, One Way ANOVA and F-tests were used for statistical analysis. Total failure (< 1 week symptomatic relief) was 20% (contrast 20%, air 14%, blind 26%). >3 months of symptomatic relief was experienced by 35%, with the air arthrogram technique containing the largest proportion of IAS achieving > 3months of relief within its own group (contrast 35%, air 38%, blind 28%). Non-smokers experienced a longer duration of symptomatic relief in the air arthrogram group (p = 0.04). Older patients had a longer duration of symptomatic relief with the blind technique (p = < 0.001). There were no significant differences between the three techniques based on the other patient variables. Air arthrogram is an effective method of confirming injection placement in hip IAS for coxarthrosis and the use of a contrast agent (e.g., Iohexol) may not be required. Non-contrast techniques may produce longer duration of symptomatic relief in non-smokers and in older patients.

Management of osteonecrosis of the humeral head in the pediatric population: A systematic review.

Humeral head osteonecrosis in the pediatric patients most often occurs in patients with underlying hemoglobinopathies, exposure to chronic corticosteroids, or after trauma. The purpose of this study was to perform a systematic review evaluating the prevalence, clinical characteristics, and management of humeral head osteonecrosis in the pediatric population. PubMed, Ovid MEDLINE, and Scopus were screened with the terms "osteonecrosis," "avascular necrosis," "pediatric," and "proximal humerus" on January 10, 2024. A total of 218 studies were screened, and 74 studies were evaluated for eligibility. Studies that reported on the prevalence and/or management of pediatric humeral head osteonecrosis were included. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Twelve studies met inclusion criteria: four retrospective case series, three prospective case series, one retrospective cohort study, one retrospective case-control study, and three case reports. A majority of the studies (67%) discussed chemotherapy-induced osteonecrosis of the humeral head. A total of 77 patients (106 shoulders) with humeral head osteonecrosis were identified. The overall prevalence of osteonecrosis of the humeral head across eight studies examining at-risk populations (underlying hemoglobinopathies or undergoing chemotherapy) was 2%. Intra-articular steroid injections, physical therapy, and activity modification are effective conservative management strategies. Additionally, core decompression and hemiarthroplasty are surgical treatment options. The prevalence of osteonecrosis of the humeral head is low even among at-risk populations with associated medical conditions. A variety of conservative and surgical treatment options have been described, but no comparative evaluations of these modalities has been conducted. IV.

Intra-articular Steroid Injection as the Etiology of Acute Pancreatitis

Intra-articular Steroid Injection as the Etiology of Acute Pancreatitis

Efficacy of Platelet-Rich Plasma Versus Hyaluronic Acid in Symptomatic Knee Osteoarthritis

Background: Osteoarthritis (OA) is one of the most common forms of arthritis and leading causes of disability. Intra-articular injection of PRP or steroid may provide benefit for patients suffering from osteoarthritis of knees, preventing, and delaying the need of a larger operative measures as many of the senile patients suffering from OA knee are quite hesitant to undergo any operative measure for the same. Materials and Methods: This was prospective type of study, with randomised selection of the patients for the assessment of outcome of treatment of symptomatic knee osteoarthritis with intra articular injections of PRP or hyaluronic acid. This study was carried out in the department of orthopaedics at our institute. In this study both injections given superolaterally weekly for 3 weeks. Study conducted over 2 years, a total of 50 patients suffering from OA knee were included in the study depending upon inclusion criteria. These patients were randomly selected for injection in a sequential manner i.e., case number 1,3,5,7 and so on sequentially were given injection HA. Case number 2,4,6,8 and so on sequentially were given injection PRP. Patients were evaluated prospectively at enrolment and at 6 weeks, 3 and 6-months follow-up with WOMAC and KSS scores. Results: PRP seems to be more efficient as compared to HA in salvaging knee in osteoarthritis. It can work as a salvaging agent in mild to moderate osteoarthritis of knee. HA injection has been found to be effective only in short term cases. Conclusion: The clinical results of this study show that both these non-surgical modalities (intraarticular injections of PRP or HA) are useful for the treatment of osteoarthritis of knee. Treatment with PRP shows significantly better outcome compared with HA group; with respect to WOMAC and KSS scores.

E028 A differential diagnosis for treatment resistant psoriatic arthritis

Abstract Background/Aims This case involves a 45 year old gentleman with established psoriatic arthritis with axial and peripheral joint involvement. His disease was managed with subcutaneous methotrexate and etanercept. Despite improvement in axial symptoms and resolution of symptoms at other peripheral joints, he had ongoing severe monoarthritis of his right knee with significant pain and swelling. Methods In spite of several joint aspirations and intra-articular steroid injections [ten in total], escalation of dose of methotrexate, addition of sulfasalazine and switch of biologic to adalimumab, the patient’s right knee symptoms persisted. Further imaging was performed. An US scan showed chronic synovial hypertrophy with fatty metaplasia and an MRI scan showed frond like synovial thickening, suggestive of lipoma arborescens. Results The patient was referred to the orthopaedic surgeons and underwent excision synovectomy. The histopathology reported fibrofatty tissue with areas of chronic synovitis with presence of lymphoplasmacytic aggregates. The patient’s knee symptoms persisted for five years in total after clinical improvement at other joints; post-synovectomy, his right knee symptoms were improved. Lipoma arborescens is a benign progressive intra-articular lesion characterised by villous lipomatous proliferation of the synovium; it frequently affects the knee joint suprapatellar pouch. Villous proliferation of the synovium occurs, with subsequent replacement of synovial connective tissue by adipocytes. Conclusion Lipoma arborescens has been described occasionally in association with psoriatic arthritis. It is felt to occur as a reactive response to chronic synovial irritation; in this case from an inflammatory affront. Given the rarity of lipoma arborescens, coupled with the patient’s known underlying diagnosis of a seronegative arthritis, there was significant delay in his diagnosis. This case highlights the need to consider other causes of persistent joint pain and swelling when maximal therapeutic options have been unsuccessful. Disclosure A. Jacobs: None. M. Callan: None.

Minimally invasive treatment for idiopathic chondrolysis of the hip: analysis of forty-one cases.

Idiopathic chondrolysis of the hip is characterized by the loss of the articular cartilage of the hip joint with spectrum ranging from full recovery to fibrous ankylosis. Study assessed outcomes following intra-articular steroid injections, joint manipulation and traction immobilization. Retrospective (2012-2021) review of 41 cases treated for idiopathic chondrolysis of hip, assessed pre-operatively and post-operatively (minimum 2-year follow-up) using Children's Hospital Oakland Hip Evaluation Score (CHOHES), visual analogue scale (VAS) and range of motion measurements. Twenty-five patients (62%) achieved painless mobility, 6 (14%) had hip stiffness without pain and 10 (24%) had painful and stiff hips at final follow-up. They had a mean age of 12.49 ± 2.4years and a mean follow-up duration of 33.15 ± 13.1months. Range of motion improved significantly (p < 0.05). VAS improved to 3.93 ± 1.3 from 7.8 ± 0.7. CHOHES improved from 29.12 ± 9.9 to 56.37 ± 17.6. Intra-articular steroid injection, manipulation and traction immobilization may effectively treat idiopathic chondrolysis of the hip by enhancing patient function and reducing the need for further surgical intervention.

Hydrodilatation and Intra-articular Steroid Injection are Both Effective in Management of Frozen Shoulder: A Case Series

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Frozen shoulder is a common problem in general orthopaedic practice, affecting about 2% of the population. Intra-articular corticosteroids (IA) and hydrodilatation have been reported as more effective among other conservative treatments. However, it is unclear which treatment is superior for frozen shoulder, and the hydrodilatation procedure leads to more discomfort in patients since it involves stretching of joint capsule. In this case series, we present 10 cases of frozen shoulder that were treated with hydrodilatation or IA steroid injection. The purpose of this study is to show the effectiveness of hydrodilatation and IA steroid injection in managing patient with frozen shoulder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was a retrospective case series of patients who received IA steroid injection or hydrodilatation. Five patients underwent IA steroid injection, and another five patients underwent hydrodilatation. The American Shoulder and Elbow Score (ASES) was used to evaluate each patient before and six months after treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result:&lt;/strong&gt; Hydrodilatation and IA steroid injection showed significant improvement in ASES score assessed at 6-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Hydrodilatation and IA steroid injection are both effective to treat frozen shoulder in long term follow up.&lt;/p&gt;

Perioperative steroid injection in elbow arthroscopy.

The goal of the present study was to evaluate the incidence of infection after perioperative intra-articular steroid injection during elbow arthroscopy. Starting from May 2019, we prospectively included all patients that underwent an elbow arthroscopy for various indications. All patients received preoperative antibiotics intravenously and a corticosteroid injection immediately after portal closure. Patients who needed ligamentous repair and aged below 18 years old were excluded. Final follow up of all patients was 3 months. In total, 108 elbow arthroscopies were performed in 100 patients. No major complications and 1 minor complication were seen. One patient developed a seroma that resolved spontaneously after 14 days without intervention or antibiotics. In this patient group, a perioperative corticosteroid injection following elbow arthroscopy did not increase the chance of infection.

Arthroscopic capsular release is more effective in pain relief than conservative treatment in patients with frozen shoulder

BackgroundFrozen shoulder is a common medical condition, but the ideal therapeutic method is yet to be determined. Our aim was to analyze the pain-relieving effect of different treatment options used for the management of this disease.MethodsMedical records of 59 patients (22 male, 37 female, average age: 55.5 years ±9.9) with early stage primary frozen shoulder were evaluated, their demographic data, physical examination, concomitant diseases and treatment specific data were registered. Life quality and the level of pain were assessed using the Oxford Shoulder Score (OSS) and Numeric Rating Scale (NRS). Different treatment modalities and their effect on pain relief were recorded. Any existing correlation between life quality, pain and demographic data, concomitant diseases or the therapeutic method used was investigated.ResultsThe level of pain measured on NRS improved from 7.9 ± 1.6 to 1.9 ± 2.2. The most effective therapeutic method in terms of pain relief was surgery, followed by physiotherapy and intraarticular steroid injection (NRS score after treatment: 2 - p < 0.0001; 3.3 - p < 0.0001; 4.9 - p < 0.0001, respectively). Non-steroidal anti-inflammatory drugs (NSAIDs) did not reduce pain significantly. OSS improved from 24 to 43.6 and was not affected by the investigated variables, time to recovery was not influenced by the demographic data, the type of treatment or concomitant diseases.ConclusionsArthroscopic capsular release, physiotherapy and intraarticular steroid injection outperformed physical therapy and NSAID treatment in terms of pain relief. Despite of slight but persistent post-therapeutic pain found in half of the cases, treatment was considered satisfactory by the patients. Nor patient specific neither therapy specific data had a significant effect on the course of the disease.