Comparison of Outcomes of Two Different Corticosteroid Injection Approaches for Primary Frozen Shoulder: A Randomized Controlled Study.
Zhibo Deng, Zhi Li, Xiangwei Li and 6 others
PMID 36597664WHAT IT FOUND
Blind anterior corticosteroid injection for frozen shoulder reduced pain more effectively than posterior injection at 4, 8, and 12 weeks.
Anterior injection also improved external rotation faster at 4 weeks. Both approaches improved function, but the anterior route offered superior pain relief and quicker recovery of specific movement.
Key findings
01Anterior injection resulted in significantly lower pain scores (VAS) at 4, 8, and 12 weeks compared to posterior injection.
02Anterior injection led to significantly better Constant-Murley shoulder scores at 4 and 8 weeks compared to posterior injection.
03External rotation range of motion was significantly better in the anterior group at 4 weeks, but no significant differences were found for flexion, abduction, or internal rotation at any time-point.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study lacked a placebo control group, so it compares two active treatments rather than proving the efficacy of the injection itself over no treatment. The sample size was relatively small (60 patients), and 7 patients were lost to follow-up or withdrew. The authors note a lack of established minimal clinically important differences (MCID) for range of motion, making it unclear if the statistical significance in external rotation translates to a meaningful clinical difference for patients.
Declared interests
The paper does not report specific funding sources or conflicts of interest in the provided text.
The easy way to misread this
Do not assume the anterior approach is universally superior for all shoulder movements. The benefit was specific to pain relief and external rotation at early time-points; there was no significant difference in flexion, abduction, or internal rotation between the two approaches.