+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study

Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study

Pain 156(9): 1683-1691

Adhesive capsulitis (frozen shoulder) is a common cause of shoulder pain and disability. Previous studies have reported that intra-articular corticosteroid injections are of benefit compared with placebo up to 6 weeks. It has been suggested that the structures primarily involved in adhesive capsulitis are the capsule and the rotator interval. Systematic reviews have concluded that there is limited evidence of the treatment effectiveness of intra-articular corticosteroid injections and that high-quality primary research is required. The aim of this study was to compare ultrasound-guided intra-articular corticosteroid injection and combined intra-articular and rotator interval injection in a double-blind, sham-controlled randomized clinical trial. The main outcome measure was the group difference in change in shoulder pain (0-10) at 6 weeks. One hundred twenty-two patients were randomized (42 to intra-articular injection, 40 to combined intra-articular/interval injection, and 40 to sham injection). For both corticosteroid injection groups, there was a significant difference compared with sham injection at week 6. The mean group difference (adjusted for gender, age, dominant arm, and duration) in change in shoulder pain for the intra-articular vs sham injection was -1.7 (95% confidence interval, -2.7 to -0.6, P = 0.002) and -2.1 (95% confidence interval, -3.2 to -1.1, P = 0.0001) for the combined injection vs sham injection. The significant group differences were maintained at week 12 but not at week 26. Similar results were found for the secondary outcome measures (night pain, Shoulder Pain and Disability Index). Differences between the corticosteroid groups were not significant at any time.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 059192628

Download citation: RISBibTeXText

PMID: 25919473

DOI: 10.1097/j.pain.0000000000000209

Related references

Single intra-articular platelet-rich plasma versus corticosteroid injections in the treatment of adhesive capsulitis of the shoulder: a cohort study. American Journal of Physical Medicine & Rehabilitation 2019, 2019

Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. Journal of Bone and Joint Surgery. American Volume 93(18): 1727-1733, 2011

Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis. Skeletal Radiology: -, 2018

Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Archives of Physical Medicine and Rehabilitation 90(12): 1997-2002, 2010

Good results after fluoroscopic-guided intra-articular injections in the treatment of adhesive capsulitis of the shoulder. Knee Surgery, Sports Traumatology, Arthroscopy 18(10): 1435-1441, 2011

Ultrasound-guided interventional release of rotator interval and posteroinferior capsule for adhesive capsulitis of the shoulder using a specially designed needle. Pain Physician 14(6): 531-537, 2012

Transforaminal versus intra-articular facet corticosteroid injections for the treatment of cervical radiculopathy: a randomized, double-blind, controlled study. Ajnr. American Journal of Neuroradiology 35(8): 1467-1474, 2015

Ultrasound-guided intra-articular injections in the wrist in patients with rheumatoid arthritis: a double-blind, randomised controlled study. Annals of the Rheumatic Diseases 67(8): 1198-1200, 2008

High- vs Low-Dose Corticosteroid Injection in the Treatment of Adhesive Capsulitis with Severe Pain: A Randomized Controlled Double-Blind Study. Pain Medicine: -, 2017

Intra-articular corticosteroid injection in diabetic patients with adhesive capsulitis: a randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy 20(10): 1947-1952, 2013

Comparing the accuracy and efficacy of ultrasound-guided versus blind injections of steroid in the glenohumeral joint in patients with shoulder adhesive capsulitis. Clinical Rheumatology (): -, 2016

Effectiveness of ultrasound-guided vs direct approach corticosteroid injections for carpal tunnel syndrome: A double-blind randomized controlled trial. Journal of Rehabilitation Medicine: -, 2018

Blind or ultrasound-guided corticosteroid injections and short-term response in subacromial impingement syndrome: a randomized, double-blind, prospective study. American Journal of Physical Medicine & Rehabilitation 91(8): 658-665, 2012

Targeted ultrasound-guided hydrodilatation via the rotator interval for adhesive capsulitis. Skeletal Radiology 44(5): 703-708, 2015

Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial. American Journal of Sports Medicine 41(5): 1133-1139, 2013