Evaluating the Effectiveness of Ultrasound-Guided Subacromial-Subdeltoid Bursa and Coracohumeral Ligament Corticosteroid Injections With and Without Physiotherapy in Adhesive Capsulitis Treatment

评估超声引导下肩峰下滑囊-三角肌下滑囊及喙肱韧带皮质类固醇注射联合或不联合物理疗法治疗粘连性肩周炎的疗效

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Abstract

Background: The objective of this study was to investigate the effect of ultrasound-guided corticosteroid injection to the subacromial-subdeltoid bursa (SSB) and coracohumeral ligament (CHL) in treating adhesive capsulitis, with a particular focus on evaluating the potential benefits of regular electrotherapy and conventional rehabilitation exercises. Methods: A total of 29 patients with unilateral shoulder pain and restricted shoulder range of motion (ROM) were included. Corticosteroids were delivered to the subacromial-subdeltoid bursa (SSB) and coracohumeral ligament (CHL) through a single percutaneous injection. Group 1 consisted of 18 patients who received injections only, while Group 2 comprised 11 patients who received injections in combination with regular physiotherapy. Shoulder Pain and Disability Index (SPADI) scores and ROM were assessed before the injection, and again at 4, 8, and 12 weeks following the intervention. A multivariate mixed-effects model with repeated measurements was conducted for the variables. Results: Electrotherapy and traditional rehabilitation exercises did not enhance the effectiveness of this injection approach. Pain, upper extremity function, and ROM in all planes were all significantly improved with a corticosteroid injection to the CHL and SSB. Conclusions: Physiotherapy did not offer additional benefits when combined with ultrasound-guided corticosteroid injection to the CHL and SSB. The injection alone significantly improved pain, disability, and ROM in patients with adhesive capsulitis. Further research is required to optimize current physiotherapy with electrotherapy and traditional rehabilitation exercises after ultrasound-guided corticosteroid injections.

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