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. 2025 Jun 24;17(6):e86639.
doi: 10.7759/cureus.86639. eCollection 2025 Jun.

Short-Term Comparative Effectiveness of Intra-articular Corticosteroid Injection Versus Hydrostatic Distention in Idiopathic Frozen Shoulder: A Prospective Interventional Study

Muhammad Anas Ghazi  1 , Slah Ud Din  2 , Zunair Aqeel  3 , Zia Ullah  4 , Tauseef Raza  5 , Kashif Anwar  6 , Mohammed Qasim Rauf  7 , Franklin E Ehizojie  8 , Aimal K Sattar  9 , Hafiz Ali Raza  10
Affiliations

Short-Term Comparative Effectiveness of Intra-articular Corticosteroid Injection Versus Hydrostatic Distention in Idiopathic Frozen Shoulder: A Prospective Interventional Study

Muhammad Anas Ghazi et al. Cureus. .

Abstract

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.

Keywords: corticosteroid injection; hydrostatic distention; idiopathic frozen shoulder; pain relief; shoulder function; spadi; vas.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board (IRB) of Lady Reading Hospital, Peshawar, Pakistan issued approval 103/LRH/MTI; dated December 11, 2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Participant Flow Diagram
Figure 2
Figure 2. Patient-Reported Satisfaction at 12 Weeks
Red dots show the percentage.
See this image and copyright information in PMC

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References

    1. Frozen shoulder. Millar NL, Meakins A, Struyf F, et al. Nat Rev Dis Primers. 2022;8:59. - PubMed
    1. 'Frozen shoulder' is ill-defined. How can it be described better? Abrassart S, Kolo F, Piotton S, Chih-Hao Chiu J, Stirling P, Hoffmeyer P, Lädermann A. EFORT Open Rev. 2020;5:273–279. - PMC - PubMed
    1. Frozen shoulder contracture syndrome - aetiology, diagnosis and management. Lewis J. Man Ther. 2015;20:2–9. - PubMed
    1. Clinical guidelines in the management of frozen shoulder: an update. Pandey V, Madi S. Indian J Orthop. 2021;55:299–309. - PMC - PubMed
    1. Living with a frozen shoulder - a phenomenological inquiry. Lyne SA, Goldblatt FM, Shanahan EM. BMC Musculoskelet Disord. 2022;23:318. - PMC - PubMed

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