Ghazi Muhammad Anas, Ud Din Slah, Aqeel Zunair, Ullah Zia, Raza Tauseef, Anwar Kashif, Rauf Mohammed Qasim, Ehizojie Franklin E, Sattar Aimal K, Raza Hafiz Ali
Trauma and Orthopaedics, North Manchester General Hospital, Manchester, GBR.
Orthopaedics, Health and Population, Tehsil Headquarter Hospital Kot Chutta, Dera Ghazi Khan, PAK.
Cureus. 2025 Jun 24;17(6):e86639. doi: 10.7759/cureus.86639. eCollection 2025 Jun.
Background Idiopathic frozen shoulder (adhesive capsulitis) is a common and debilitating condition, characterized by progressive restriction of shoulder movement. Non-randomized interventional treatments, such as intra-articular corticosteroid injections and hydrostatic (hydrodilatation) distention, are commonly employed when conservative therapy fails. Objective The main objective of this study is to compare the short-term effectiveness of intra-articular corticosteroid injection versus hydrostatic distention, in terms of pain relief and functional improvement in patients with idiopathic frozen shoulder. Methods This prospective, single-center, comparative interventional study was conducted at Lady Reading Hospital, Peshawar, Pakistan. A total of 108 patients, aged 35-70 years, with frozen-phase idiopathic frozen shoulder (>3 months' duration), were assigned to two treatment groups using non-random, consecutive allocation: Group A (n = 54) received an intra-articular corticosteroid injection, and Group B (n = 54) underwent hydrostatic shoulder distention. Patients were assessed at baseline, 4 weeks, and 12 weeks using the Visual Analog Scale (VAS) for pain and the Shoulder Pain and Disability Index (SPADI) for function. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, NY, USA). Results Both groups showed significant improvements in pain and function over time (p < 0.001). However, Group A demonstrated superior outcomes at 12 weeks in VAS (2.1 ± 0.9 vs. 2.6 ± 1.0; p = 0.027) and SPADI (28.6 ± 6.3 vs. 32.9 ± 6.5; p = 0.006). "Very satisfied" patients were more frequent in Group A (28 patients; 64.81%) than in Group B (35 patients; 51.85%). Conclusion Intra-articular corticosteroid injection appears to be more effective than hydrostatic shoulder distention in providing short-term pain relief, functional improvement, and higher patient satisfaction in idiopathic frozen shoulder. Further studies, with randomized designs and long-term follow-up, are warranted.
特发性冻结肩（粘连性关节囊炎）是一种常见且使人衰弱的病症，其特征为肩部活动逐渐受限。当保守治疗失败时，常采用非随机介入治疗，如关节内注射皮质类固醇和液压（水扩张）扩张术。目的：本研究的主要目的是比较关节内注射皮质类固醇与液压扩张术在缓解特发性冻结肩患者疼痛和改善功能方面的短期疗效。方法：这项前瞻性、单中心、对比性介入研究在巴基斯坦白沙瓦的莱迪·里德医院进行。共有108例年龄在35至70岁之间、处于冻结期的特发性冻结肩（病程超过3个月）患者，采用非随机、连续分配的方式分为两个治疗组：A组（n = 54）接受关节内注射皮质类固醇，B组（n = 54）接受肩部液压扩张术。使用视觉模拟评分法（VAS）评估疼痛程度，使用肩痛和功能障碍指数（SPADI）评估功能，在基线、4周和12周时对患者进行评估。使用IBM SPSS Statistics for Windows，版本25（2017年发布；IBM公司，美国纽约州阿蒙克）进行统计分析。结果：两组患者的疼痛和功能随时间均有显著改善（p < 0.001）。然而，A组在12周时的VAS评分（2.1 ± 0.9 vs. 2.6 ± 1.0；p = 0.027）和SPADI评分（28.6 ± 6.3 vs. 32.9 ± 6.5；p = 0.006）显示出更好的结果。A组“非常满意”的患者（28例；64.81%）比B组（15例；51.85%）更常见。结论：在特发性冻结肩的短期疼痛缓解、功能改善和提高患者满意度方面，关节内注射皮质类固醇似乎比肩部液压扩张术更有效。有必要进行进一步的随机设计和长期随访研究。
