Frozen Shoulder: Role of Single Intra-Articular Corticosteroid Injection and Home Exercise Programme

OBJECTIVE: To observe the affects of intra-articular steroid injection followed by simple home exercise programme in patients with primary frozen shoulder phase I and phase II. MATERIAL AND METHODS: Eighty five patients with idiopathic (primary) frozen shoulder, clinical phase I and II with unilateral involvement with minimum duration of six months were selected for the study. The solution injected contained 5cc of 1% lidocaine HCl (xylocain) and 2cc (80mg) methyl prednisolone acetate (depomedrol). All patients were injected once. The glenohumeral joint was injected via posterior approach. The site of entry was same as used for traditional posterior portal for arthroscopy of shoulder. After the inra-articular injection, patients were advised to perform range of movements exercise within the limits of pain daily for ten minutes. Systemic documentation of shoulder function was made before the treatment and six months after the intra-articular injection by obtaining simple shoulder test (SST) RESULTS: All the 15 patients in clinical phase I recovered in the mean time of seven weeks. (Range 3 weeks to 3 months). Fifty out of seventy patients in clinical phase II recovered in the mean time of 4 months. (Range 3 weeks to 6 months) Twenty patients did not meet the recovery criteria within six months after injection. CONCLUSION: In patients with frozen shoulder, single intra-articular injection of corticosteroid combined with simple home exercise program is effective in improving shoulder pain and disability.