scholarly journals ADHESIVE CAPSULITIS; MANAGEMENT BY PHYSIOTHERAPY VERSUS INTRA-ARTICULAR CORTICOSTEROID INJECTION

2021 ◽  
Vol 71 (5) ◽  
pp. 1824-27
Author(s):  
Muhammad Umair Hashmi ◽  
Babar Bakht Chughtai ◽  
Muhammad Nadeem Ahsan
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Sampling Technique ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Group A ◽  
Group B

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.

scholarly journals Evaluating the Outcome of Two Different Regimes in Adhesive Capsulitis: A Prospective Clinical Study

2019 ◽  
Vol 29 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Rashid Anjum ◽  
Jatin Aggarwal ◽  
Rakesh Gautam ◽  
Subodh Pathak ◽  
Aryan Sharma
Keyword(s):  
Clinical Study ◽  
Steroid Injection ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Tertiary Care ◽  
Frozen Shoulder ◽  
Prospective Clinical Study ◽  
Painful Condition ◽  
Group A ◽  
Group B

Objective: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder. Methods: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B). Results: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B ­compared to group A, and improvement was significant at 6 weeks and 3 months. Conclusion: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone.

scholarly journals Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage

2020 ◽  
Vol 18 (1) ◽  
pp. 15-17
Author(s):  
Gopal Sagar DC
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Corticosteroid Injection ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

THE ROLE OF MANUAL THERAPY IN THE TREATMENT OF CHRONIC CERVICAL PAINS

2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu
Keyword(s):  
Manual Therapy ◽  
Therapy Group ◽  
Neck Disability Index ◽  
Initial Assessment ◽  
Visual Analogue Pain Scale ◽  
Rehabilitation Protocol ◽  
Visual Analogue Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).

scholarly journals Immediate Effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Pain in Diabetic Patients with Periarthritis of Shoulder

2021 ◽  
pp. 220-228
Author(s):  
Kamya Somaiya ◽  
G. D. Vishnu Vardhan ◽  
Ashish Bele
Keyword(s):  
Quality Of Life ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Tissue Degeneration ◽  
Muscle Energy Technique ◽  
Group A ◽  
Muscle Energy ◽  
Group B

Background: Periarthritis Shoulder, also known as adhesive capsulitis, is a condition that results in tissue degeneration, thickening of the joint capsule, and a narrowing of the glenoid cavity. Diabetes mellitus is linked to many debilitating musculoskeletal disorders of the hand and shoulder. Prevalence of adhesive capsulitis or frozen shoulder is estimated to be 11-30 percent in people with diabetes. Various interventions have already been used to prevent pain and improve quality of life. Both Muscle Energy Technique and Kalternborn Mobilization Technique are thought to have a pain-relieving effect. Aim & Objective: The study's aim is to compare the effects of both techniques on pain in diabetic patients. Methods/Design: In this study experimental study, the participants will be divided into two groups: Kalternborn Mobilization Technique Group (A) and Muscle Energy Technique Group (B) based on inclusion and exclusion criteria. Both interventions include 30-45 min session which will be carried out for duration of four days. Outcome will be Pain and Quality of Life and outcome measures will be evaluated at beginning and at the end of intervention period. Result: Successful Completion of trial of Muscle Energy Technique and Kalternborn Mobilisation Technique will provide evidence for best strategy targeting Pain and quality of life in diabetic patients with Periarthritis of Shoulder. Conclusion: The study will be concluded with the significant effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Periarthritis shoulder of diabetic patients.

scholarly journals A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha
Keyword(s):  
Range Of Motion ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Equal Frequency ◽  
Steroid Injections ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dominant Side

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 

scholarly journals COMPARISON OF TRIGGER POINT PRESSURE RELEASE WITH ULTRASOUND THERAPY TO DECREASE RHOMBOIDS TRIGGER POINTS PAIN

2016 ◽  
Vol 5 (2) ◽  
pp. 32-36
Author(s):  
Azam Mahmood ◽  
Saad Saleem ◽  
Muhammad Usman Khan
Keyword(s):  
Pain Score ◽  
Outcome Measures ◽  
Trigger Point ◽  
Sampling Technique ◽  
P Value ◽  
Ultrasound Therapy ◽  
Pressure Release ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVE To compare the effects of trigger point (TrP) pressure release with ultrasound therapy to reduce rhomboid pain due to TrP. STUDY DESIGN Experimental study STUDY SETTINGS Outpatient department of Ziauddin Hospital, Clifton campus, Karachi, Pakistan. SAMPLE SIZE 50 patients SAMPLING TECHNIQUE Simple random sampling. The patients were divided into two groups of 25. Group A were given TrP pressure release treatment with exercise and group B were given ultrasound (u/s) treatment with exercise. OUTCOME MEASURES The outcome measures were visual analog scale (VAS) for pain and functional rating index (FRI) for functional performance RESULTS In group A, mean pain score on VAS before the treatment were 5.88±1.130 and after treatment were 1.80±1.041 with a p-value of <0.006. Group B, mean pain score on VAS before treatment were 6.56±1.446, after treatment were 2.72±1.208, with a p-value of <0.006. The mean FRI in group A before treatment was 39.92 ± 2.691 and after treatment was 29.60 ± 5.454, with a p-value of 0.002. The mean FRI in Group B before treatment was 41.12 ± 2.505 and after treatment was 35.92 ± 4.183, with a p-value of 0.002.

scholarly journals PREVALENCE AND MANAGEMENT OF THE DIABETIC FROZEN SHOULDER

2020 ◽  
Vol 8 (10) ◽  
pp. 944-954
Author(s):  
Niraj Kumar ◽  
Keyword(s):  
Functional Ability ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Treatment Strategies ◽  
Insidious Onset ◽  
Group A ◽  
Shoulder Syndrome ◽  
Shoulder Condition ◽  
Group B

The term frozen shoulder was first introduced by Codman in 1934. He described a painful shoulder condition of insidious onset that was associated with stiffness and difficulty sleeping on the affected side. Codman also identified the marked reduction in forward elevation and external rotation that are the hallmarks of the disease. Long before Codman, in 1872, the same condition had already been labelled periarthritis by Duplay. In 1945, Naviesar coined the term adhesive capsulitis. [2] The pathophysiology of idiopathic adhesive capsulitis (frozen shoulder) is poorly understood. Most authors have reported various degrees of inflammatory changes in the synovial membrane. Adhesions between the shoulder capsule and the humeral head have been noted by some, but not all, authors. [4] The aetiology of periarthritis of the shoulder, however, is not clearly understood. Amongst the factors suggested are trauma myocardial infarction hemiplegia, pulmonary tuberculosis, thyrotoxicosis, cerebral tumour, and epilepsy. [7] Subjects with Frozen Shoulder Syndrome group A treated with ERM and MWM and group B treated with MRM. The duration of each treatment was 3 weeks. There was an improvement in mobility and functional ability at 12 weeks in subjects treated with the 3 mobilization techniques. Comparing the effectiveness of the 3 treatment strategies in subjects with unilateral Frozen Shoulder Syndrome, ERM and MWM were more effective than MRM in increasing mobility and functional ability. [22].

scholarly journals A comparative clinical study on the efficacy of Nasya with Pinyaka / Panchamula Taila and Swalpa Masha Taila in Apabahuka w.s.r. to frozen shoulder

2020 ◽  
Vol 5 (04) ◽  
pp. 31-36
Author(s):  
Conception Costa ◽  
Sudarshan A. ◽  
Jeejo Chandran O
Keyword(s):  
Clinical Study ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Modern Medicine ◽  
Study Group ◽  
Inclusion Criteria ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
Single Blind

Background: Apabahuka is a Vataja Nanatmaja Vyadhi, in which locomotive functions of Amsa Sandhi are affected mainly due to Vata Dosha Prakopa causing pain, stiffness and restricted movement of the shoulder. Apabahuka can be correlated to Frozen shoulder or Adhesive Capsulitis in modern medicine because of similar symptomatology. Nasya is indicated in Urdhwajatrugata Vikaras. Pinyaka Taila and Swalpa Masha Taila are Vatahara Taila used for Nasya. Method: A single blind randomised clinical study in which 40 clinically diagnosed patients of Apabahuka, fulfilling the inclusion criteria were selected and divided into two groups - Group A treated with Pinyaka / Panchamula Taila Nasya and Group B treated with Swalpa Masha Taila Nasya, comprising of 20 patients each. Result: Statistically Nasya with Pinyaka Taila showed better results in Pain (51.2%), Stiffness (48%), Tenderness (58.33%), with improvement in goniometric readings of shoulder ROM than Nasya with Swalpa Masha Taila in Pain (39.4%), stiffness (40.9%), Tenderness (58%). Discussion: Rukshadi Gunas of Vata are increased in Apabahuka hence Viparita Gunas like Snigdhadi in the form of Brumhana Nasya with Pinyaka Taila was found to be effective in Apabahuka. In the present study Group A Nasya with Pinyaka Taila showed better effect than Group B Nasya with Swalpa Masha Taila.

scholarly journals COMPARISON OF EFFICACY OF INJECTABLE STEROIDS VERSUS CONSERVATIVE MANAGEMENT FOR DE QUERVAINS’S TENOSYNOVITIS

2021 ◽  
Vol 12 (3) ◽  
pp. 217-221
Author(s):  
Nasim Ilyas ◽  
Fouzia Hanif ◽  
Rajesh Kumar Panjwani ◽  
Sheikh Kashif Rahim ◽  
Asma Abdul Qadeer ◽  
...  
Keyword(s):  
Conservative Management ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Post Intervention ◽  
De Quervain’S Tenosynovitis ◽  
Management Group ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

BACKGROUND & OBJECTIVE: De Quervain's tenosynovitis is tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons, occurs due to chronic overuse of the wrist and hand. To compare effectiveness of steroid injection with conservative management of De Quervains’s tenosynovitis. METHODOLOGY: Randomized prospective study was conducted at the various private orthopedic clinic across Rawalpindi district, along with collaboration of community medicine department, Rawal Institute of health sciences, Islamabad. The study population was divided into two groups, i.e., group A and group B. Group A was given inj. corticosteroid and group B was given conservative management. The severity of pain (Visual analogue scale) and Finkelstein test were recorded on baseline and after 3 weeks follow up. RESULTS: Our study included 96 diagnosed cases of de Quervains tenosynovitis on a positive Finkelstein test; 48 were given corticosteroid injection and 48 were conservatively treated. The mean age in corticosteroid’s injection group was 34.76+6.95 years whereas the mean age in conservative management group was 31.7+8.91 years. Post-intervention 13, 29 patients had a positive Finkelstein test in corticosteroid and conservative groups respectively. Although the difference in pre intervention pain score between the two groups was not statistically significant but significantly lesser pain scores in the corticosteroid group; (p= 0.00). CONCLUSION: Steroid injection produced better results in terms of relief in pain and negative Finkelstein test as compared to conservative treatment.

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