Thawing frozen shoulder by steroid injection

Area of Science:

• Orthopedics
• Sports Medicine
• Rheumatology

Background:

• Frozen shoulder (adhesive capsulitis) is a common condition.
• Steroid injections into the glenohumeral joint are a known treatment, but outcomes vary.
• Understanding pathology and biomechanics is key to improving treatment efficacy.

Purpose of the Study:

• To evaluate the short- and long-term efficacy of a novel three-site (NTS) steroid injection technique.
• To compare the NTS technique with the standard single-site injection (SSI) for frozen shoulder.

Main Methods:

• Prospective study of 85 patients with frozen shoulder.
• Two randomized groups: SSI (posterior approach) and NTS (posterior capsule, subacromial, subcoracoid).
• Steroid injections repeated after 3 weeks; both groups received physiotherapy. Evaluated using CONSTANT score at multiple time points.

Main Results:

• NTS group showed significant pain relief and earlier improvement in daily living activities (p < 0.005).
• Both groups improved shoulder movement, but NTS achieved early, sustained near-normal scores.
• 43% of SSI patients did not reach near-normal levels and experienced relapses.

Conclusions:

• The three-site steroid injection technique is safe and effective for frozen shoulder.
• NTS provides earlier recovery and superior functional improvement with reduced relapse rates.
• This novel approach enhances treatment outcomes for adhesive capsulitis.