Adhesive capsulitis of the shoulder: an open study of 40 cases treated by joint distention during arthrography followed by an intraarticular corticosteroid injection and immediate physical therapy.

OBJECTIVE

To evaluate the short- and long-term efficacy of joint distention during arthrography followed by an intraarticular corticosteroid injection then by high-intensity physical therapy and use of an abduction splint in an open study of 40 patients with adhesive capsulitis of the shoulder.

METHODS

Patients were evaluated on D0, D5 (i.e., before discharge) and D30 for pain severity assessed using a four-point scale (0-3) and for passive ranges of abduction, internal rotation and external rotation of the shoulder.

RESULTS

Mean pain severity improved significantly from 2.18 +/- 0.6 (mean +/- SD) on D0 to 1.74 +/- 0.5 on D5 (P: 0.01) and 0.92 +/- 0.5 on D30 (P: 0.02). Passive range of abduction increased significantly from 44.8 degrees +/- 1.54 degrees on D0 to 68 degrees +/- 15 degrees on D5 (P: 0.05), whereas the difference between D5 and D30 (71 degrees +/- 13 degrees) was not significant (P: 0.8). Similarly, passive range of external rotation increased significantly from 4.3 degrees +/- 0.6 degree on D0 to 13.5 degrees +/- 0.5 degree on D5 (P = 0.04) and showed a nonsignificant increase from D5 to D30 (17 degrees +/- 13 degrees, P: 0.2).

CONCLUSION

Joint distention during arthrography followed by an intraarticular corticosteroid injection then by high-intensity physical therapy significantly improved pain and passive range of motion within the first five days, and these gains were sustained after one month.