Mandar S. Shaha1, Pradeep N. Kulkarni2, Nithin S. Patil3, Nagesh R. Desai4, Nirav S. Patel5,Himanshu G. Kulkarni6
Although many treatment options have been advocated for the self-limiting disease of the frozen shoulder, there is no robust evidence of the superiority of one over other. This study intended to evaluate the outcome of hydrolic capsular distension followed by physiotherapy and its comparison with only physiotherapy regime in treatment of frozen shoulder.
AIMS AND OBJECTIVES: Evaluate the additional benefit of the hydrolic capsular distension using normal saline and steroid in the management of the frozen shoulder treated with conventional physiotherapy
MATERIALS AND METHODS: In this randomized prospective study we have studied total 50 cases within the age group of 40-70 years with idiopathic frozen shoulder. They were divided into two groups of 25 patients each. Patients in the first group were treated with shoulder joint capsular distension using normal saline and steroid under local anesthesia at outpatient department followed by physiotherapy and the patients in second group were treated with physiotherapy only. The aim was to obtain earlier pain relief and earlier relief from functional disability. Shoulder pain and disability index (SPADI) & Visual analogue scale (VAS) score was used as a tool for evaluation and comparison.
RESULTS: After confounding all the demographic factors it was found that the intra as well as inter group change in SPADI score revealed statistically extremely significant difference (p value - <0.0001) at the end of 12th week. Hydrotherapy group being superior than the only physiotherapy group. VAS score showed statistically extremely significant improvement in hydrotherapy group at the end of 1 st week (p value- <0.0001) as compared to not much improvement in only physiotherapy group (p value - 0.0830). Similar results were observed with the SPADI score values at the end of first week, where 80% patient in hydrotherapy group felt some improvement in performing daily activities at the same time no one was quoted to say so in only physiotherapy group.
CONCLUSION: From this study we conclude that in the management of frozen shoulder hydrolic capsular distension with intra-articular steroid and normal saline followed by physiotherapy gives dramatic relief from pain as early as within the first week. The improvement from the functional limitation is also earlier and the effects remain sustained till 12 weeks as compared to only physiotherapy regimen.
