The Use of Corticosteroid/Anesthetic Injections in Conjunction With Physical Therapy in the Treatment of Idiopathic Frozen Shoulder: A Case Series

Abstract

Background Fifty percent of people diagnosed with frozen shoulder (FS) experience pain and/or stiffness for years after onset, and the best conservative treatment for this condition remains uncertain. This case series evaluated the clinical results of intra-articular corticosteroid and anesthetic injections, combined with a specific physical therapy program, in the treatment of FS. Case Presentation The research is based on 26 patients with idiopathic FS. The patients were treated with unguided intra-articular corticosteroid and anesthetic injections, painful/end-range mobilization techniques, and painful/end-range home stretching exercises. Range of motion was measured and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), and the Medical Outcomes Study 36-Item Short- Form Health Survey (SF-36) were administered at 5 follow-up sessions over 3 months. Outcome and Follow-Up The 90% confidence intervals of the mean range-of-motion scores for flexion, extension, internal rotation, and external rotation at 90° and at 0° of abduction did not show significant differences at 3-month follow-up between the affected shoulder and the healthy one. Between baseline and 3-month follow-up, the average DASH difference was 37%, and all scores exceeded the minimal clinically important difference of the DASH. The score on the bodily pain subscale of the SF-36 improved by 43% from baseline to 3-month follow-up. Discussion From our clinical experience and the analyzed data, intra-articular corticosteroid and anesthetic injections, combined with the above-mentioned mobilizations and a simple home exercise program, are effective at improving shoulder pain, range of motion, and disability in the short term. JOSPT Cases 2021;1(4):248–265. doi:10.2519/josptcases.2021.9960