Comparison of the analgesic efficacy of intra articular steroid injections and combination therapy with supra-scapular nerve block in patients with adhesive capsulitis of the shoulder joint

Adhesive capsulitis, or “frozen shoulder,†is a condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion. Though considered a self-limited disease, some residual stiffness may remain even after the resolution of capsular inflammation, thereby severely impairing the quality of life of these patients. Thus, early diagnosis and treatment of this condition provides favorable outcome, i.e., symptomatic relief and early improvement in the range of movements (ROM). 

Treatment modalities for adhesive capsulitis include medication, intra-articular steroid injection, nerve blocks, physiotherapy, manipulation under anaesthesia and capsular release. Currently there is no consensus as to the most efficacious treatment.  In our study, we propose to find and compare the effects of intra-articular steroid injections alone and in combination therapy with supra-scapular nerve block in patients with adhesive capsulitis of the shoulder joint.

Few observational studies have studied the efficacy of intra-articular steroid injections and supra-scapular nerve block in adhesive capsulitis. There are no available RCTs, in literature, that have compared the effects of these two modalities singly or in combination therapy among the Indian population.

We propose that use of intra-articular steroid injections, or combination therapy with supra-scapular nerve block together with physical therapy will provide cost effective and quicker outcomes in terms of symptomatic relief and overall improvement in quality of life. The results of this study will help us to choose an ideal intervention technique for patients with adhesive capsulitis.