Comparison of the Mean Decrease of Pain Score (according to ULCA Shoulder Rating Scale) with Intra Articular NSAID Injection Versus Steroid Injection for the Management of Adhesive Capsulitis

Abstract

Objective: Adhesive capsulitis is a common condition in which the shoulder capsule swells and
stiffens, restricting its mobility. It is a common cause of shoulder pain and disability, estimated to
affect 25% of the general population. The objective of the study was to compare the mean
decrease of pain scores (according to ULCA shoulder rating scale) with intra-articular non-
steroidal anti inflammatory (NSAID) injection versus steroid injection for the management of
adhesive capsulitis of the shoulder.
Material and Methods: A Randomized controlled trial was carried out in Department of
Orthopedic Surgery at Services Hospital Lahore from September 2012 to March 2013. A total of
150 patients with adhesive capsulitis of the shoulder were included in the study and were
assigned into two groups using random number table. Group A patients received intra-articular
NSAID (Ketorolac) and Group B patients were treated with intra-articular steroid (Triamcinolone)
injection for the treatment of adhesive capsulitis. The pain scores were recorded before and four
weeks after the intra-articular injections using ULCA shoulder rating scale.
Results: The age distribution of the 150 patients shows that majority of the patients i.e. 37.33%
(n=28) in Group A and 33.33% (n=25) in Group B were between 51-60 years, mean and SD was
calculated as 53.55+5.11 and 55.21+5.76 years respectively. In Group-A 45.33% (n=34) and in
Group-B 48% (n=36) were males whereas 54.67% (n=41) and 52% (n=39) were females. The
pre-treatment pain score in both groups was recorded as 4.43+1.76 in Group A and 5.92+1.31 in
Group B. The post-treatment pain score was 7.95+0.32 in Group A and 6.76+0.63 in Group B
(p=0.01), showing significant difference in both groups.
Conclusion: The intra-articular NSAIDs injection is a more effective treatment option compared
to intra-articular steroid injection for the management of adhesive capsulitis of the shoulder