Comparative study of treatment with intra-articular corticosteroid injection and nsaid in adhesive capsulitis of shoulder in diabetic patients; a randomized clinical trial

Adhesive capsulitis commonly presents with pain and limitation of both active and passive shoulder movements. It involves the glenohumeral joint and is relatively more common condition encountered in elderly and among diabetic patients. The incidence among the diabetic group of patients is 10-20%. Diabetic patients with adhesive capsulitis present with severe stiffness and pain and should be treated actively. The treatment modalities include intra-articular corticosteroid injection, NSAIDs and physiotherapy. In this study we compare the efficacy of intra articular corticosteroid injection with NSAIDs in adhesive capsulitis of diabetic patients. Method: The study was conducted during Feb 2016-Aug 2017 on diabetic patients with adhesive capsulitis in Department of orthopaedics, Sree Balaji medical college and hospital. Pain and the limitation of range of movements in all the directions were taken as our diagnostic criteria. The patients were divided into 2 groups, of which the first received NSAID and the second group undergone intra- articular corticosteroid injection. Exercises in the home were started after 1 week, for both the groups. Patients were evaluated in 2nd, 6th, 12th and 24th weeks. SPSS-15 software were used to compare and analyze the data. Results: 57 patients of which 19 were males (33.3 %) and 38 were females (66.7 %) are included in the study. There is significant difference noted between sex (P = 0.4) and age (P = 0.19) of patients. No significant relation was seen between 2 groups after 24 weeks considering the range of motion in flexion (P = 0.51), range of motion in abduction (P = 0.76), range of motion in external rotation (0.12) and range of motion in internal rotation (P = 0.91). There is also any significant difference in pain score was not detected (P = 0.91). Conclusion: Our study showed that there is no significant difference in efficacy in diabetic patients with adhesive capsulitis treated with both intraarticular corticosteroid and NSAID’s.