Background: Adhesive capsulitis (AC) causes shoulder pain and limited range of motion. While ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy are effective individually, their combined use is not well-studied.
Objective: This study evaluates the effect and safety of combining ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy on range of motion and pain, comparing diabetic and non-diabetic patients.
Design: Retrospective Cohort; Level of Evidence 3.
Methods: 150 patients (30-75 years) with AC received ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation with corticosteroid injection, and subsequent physical therapy. Baseline Visual Analog Scale (VAS) pain score, active forward flexion, and external rotation range of motion were measured using a goniometer. At 3 months post-procedure, range of motion and pain were reevaluated.
Results: Significant improvements in active forward flexion (median improvement of 25 degrees) and external rotation (median improvement of 19 degrees) were observed at 3 months (p < 0.001). No complications were reported.
Conclusion: Combining ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy is safe, effective, and improves pain, flexion, and external rotation range of motion in patients with adhesive capsulitis.
Keywords: Ultrasound-guided; adhesive capsulitis; frozen shoulder; glenohumeral joint; hydrodilatation; suprascapular nerve.
Adhesive capsulitis (AC), or frozen shoulder, causes pain and limits shoulder movement. This study tested the effects of combining three treatments: a suprascapular nerve block (a numbing injection to a shoulder nerve), hydrodilatation (injecting fluid into the shoulder joint), and manual stretching with physical therapy after the injections. The primary goal was to see if this combination reduces pain and improves range of motion while comparing outcomes in diabetic and non-diabetic patients.The study included 150 patients aged 30–75 years. Pain levels and shoulder movements were measured before treatment and again at 3 months afterward. The results showed significant improvements in both pain and shoulder movement. On average, patients improved by 25 degrees moving their arm forward and 19 degrees in turning their arm outwards. The treatment was found to be safe, no complications reported.Both patients with and without diabetes saw improvements, but diabetic patients showed slightly less progress. This suggests that the combined treatment works for all patients, but diabetics may need additional support.In conclusion, the combination of these three treatments is a safe and effective for managing AC, leading to significant pain relief and improved shoulder movement. Further research could explore how each treatment works on its own rather than just in the combined fashion.