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Related Experiment Video

Updated: Jul 8, 2025

Rat Model of Adhesive Capsulitis of the Shoulder
04:46

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Nitrous oxide provided during intensive physiotherapy for shoulder adhesive capsulitis does not improve function: A

Arnaud Dupeyron1, Lech Dobija2, Christel Castelli3

  • 1Department of Physical Medicine and Rehabilitation, CHU Nîmes, Univ Montpellier, Nîmes, France; EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France.

Annals of Physical and Rehabilitation Medicine
|December 20, 2023
PubMed
Summary

Nitrous oxide (N2O) with physiotherapy did not improve shoulder function in adhesive capsulitis patients. However, N2O may reduce pain during physiotherapy sessions, though it was associated with more adverse events.

Keywords:
Adhesive capsulitisAnalgesiaNitrous oxidePhysiotherapyRehabilitationShoulder

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Area of Science:

  • Orthopedics
  • Pain Management
  • Rehabilitation Medicine

Background:

  • Adhesive capsulitis treatment lacks consensus, with physiotherapy often causing pain.
  • This study investigated nitrous oxide (N2O) as an adjunct to physiotherapy for shoulder adhesive capsulitis.

Purpose of the Study:

  • To determine if N2O combined with physiotherapy improves pain and function in shoulder adhesive capsulitis compared to physiotherapy alone.
  • To assess the impact of N2O on pain during mobilization and overall shoulder function.

Main Methods:

  • A double-blind, randomized controlled trial involving 69 adult participants with adhesive capsulitis.
  • Participants received 20 sessions of intensive physiotherapy over 10 days, with 10 sessions involving either N2O or placebo gas.
  • Shoulder function was assessed using the Constant-Murley score at day 14.

Main Results:

  • No significant difference in shoulder function (Constant-Murley score) was observed between the N2O and placebo groups at day 14.
  • A reduction in pain during physiotherapy sessions was noted in the N2O group (p=0.053) but not the placebo group.
  • More adverse events, including shortness of breath, were reported in the N2O intervention group.

Conclusions:

  • Nitrous oxide combined with intensive physiotherapy does not offer superior improvements in shoulder function or quality of life for adhesive capsulitis.
  • While N2O may reduce pain during physiotherapy, its overall benefit is limited by a lack of functional improvement and increased adverse events.