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Corticosteroid Injections for Adhesive Capsulitis: A Review
Ryan C Xiao1, Kempland C Walley, Joseph P DeAngelis
1*Harvard Medical School, Brookline, Massachusetts; †Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and ‡Department of Orthopaedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Corticosteroid injections offer short-term symptom relief for adhesive capsulitis (AC) but lack long-term benefits. Further research is needed to confirm efficacy, especially with ultrasound guidance for frozen shoulder treatment.
Area of Science:
- Orthopedics
- Rheumatology
- Sports Medicine
Background:
- Adhesive capsulitis (AC), or frozen shoulder, is a condition with prolonged symptom duration, often resolving within 2-3 years.
- While many cases are managed nonoperatively, a subset of patients requires surgical intervention.
- The efficacy of corticosteroid injections for AC remains a key area of investigation.
Purpose of the Study:
- To systematically review the effectiveness of corticosteroid injections in treating adhesive capsulitis (AC).
Main Methods:
- A comprehensive literature search was conducted using PubMed, focusing on studies related to AC and corticosteroid injections.
- Inclusion criteria involved studies detailing treatments for AC, frozen shoulder, stiff shoulder, or painful shoulder using corticosteroids, glucocorticoids, or steroid injections.
Main Results:
- Corticosteroid injections provide temporary symptom relief lasting 2 to 24 weeks.
- Intra-articular or subacromial space injections are common administration routes.
- Evidence suggests comparable efficacy between 20 mg and 40 mg triamcinolone doses, though outcomes with image-guided versus landmark-guided injections require further clarification.
- Potential reduced benefit in diabetic patients and a contraindication for triamcinolone in patients on protease inhibitors (due to risk of iatrogenic Cushing syndrome) were noted.
Conclusions:
- Corticosteroid injections offer short-term relief for adhesive capsulitis but do not appear to provide sustained long-term benefits.
- High-quality prospective studies are necessary to ascertain the significant impact of ultrasound-guided corticosteroid injections on AC outcomes.
