From the Research
Steroid injections are beneficial after adhesive capsulitis release surgery to reduce inflammation, manage pain, and prevent recurrence of adhesions. A single intra-articular corticosteroid injection, typically using triamcinolone acetonide (20mg) mixed with local anesthetic, is commonly administered either during surgery or within the first few weeks post-operatively, as studies have shown that lower doses can be as effective as higher doses in managing symptoms 1, 2, 3. This intervention helps reduce inflammation, manage pain, and potentially prevent recurrence of adhesions during the critical healing phase. The steroid works by suppressing the inflammatory cascade that contributes to pain and fibrosis, while the local anesthetic provides immediate pain relief. Some key points to consider when administering steroid injections include:
- Patients should be informed that they might experience temporary increased pain or "steroid flare" for 24-48 hours after injection, followed by improvement.
- Physical therapy should begin promptly after surgery regardless of steroid administration, as early mobilization is crucial for maintaining the range of motion achieved during the surgical release.
- For diabetic patients, blood glucose monitoring is recommended for 1-2 weeks post-injection as steroids can temporarily elevate blood sugar levels.
- While generally safe, these injections should be limited to 3-4 per year in the same joint to avoid potential complications such as cartilage damage or tendon weakening. It's also worth noting that the optimal dose of intra-articular corticosteroids for adhesive capsulitis is still a topic of debate, but recent studies suggest that lower doses may be sufficient 1, 2, 3. Additionally, the use of ultrasound-guided injections can improve the accuracy of the injection and reduce the risk of complications 3. Overall, the use of steroid injections after adhesive capsulitis release surgery can be an effective way to manage symptoms and improve outcomes, but it's essential to carefully consider the potential benefits and risks and to individualize treatment for each patient.