Corticosteroid Injections for Pain Relief and Range of Motion in Adhesive Capsulitis

Adhesive capsulitis (frozen shoulder) is a chronic, painful shoulder condition characterized by progressive stiffness and restricted range of motion. Despite its prevalence, there is limited evidence, particularly in our regional population, regarding the optimal timing, dosage, and technique of corticosteroid injection to achieve maximal pain relief and functional recovery. The objective of this study was to evaluate the efficacy of intra-articular corticosteroid injections in patients with adhesive capsulitis, as measured by pain reduction and improvement in range of motion (ROM). Efficacy was defined as a reduction in pain exceeding the minimal clinically important difference (MCID) of 1.5 points on the visual analog scale (VAS) and an improvement in ROM of at least 20° in forward flexion or external rotation compared to baseline at the 12-week follow-up.

This quasi-experimental study was conducted at the Orthopedic and Spine Department, Khyber Teaching Hospital, Peshawar, from January 5, 2024, to July 5, 2024. A total of 148 patients of both genders with adhesive capsulitis were included. After using aseptic technique, a solution containing 80 mg/mL Depo-Medrol and 2% lignocaine was injected into the affected shoulder joint via a posterior approach using a blind technique. Patients were followed weekly for 12 weeks. Efficacy was assessed at the end of the follow-up period, based on pain relief and improvement in range of motion. No adjuvant therapy, such as physiotherapy, was administered during the study period.

The mean age of the patients was 48.99±10.03 years, with a mean BMI of 25.07±2.06 kg/m², a baseline VAS score of 6.12±1.21, and an average symptom duration of 13.17±5.06 weeks. At the end of the 12-week follow-up period, efficacy was defined as pain relief and improvement in range of motion, which were achieved in 53.4% of patients.

Intra-articular corticosteroid injections are moderately effective in the treatment of adhesive capsulitis, with just over half of the patients experiencing positive outcomes.