From the Guidelines
Steroid injection after adhesive capsulitis release surgery is not recommended as it may not loosen the shoulder joint and could potentially have deleterious effects on the tendon. The use of locally injected corticosteroids is a topic of debate, and more research in this area is needed, as stated in a study published in the American Family Physician in 2005 1. The optimal drugs, dosages, techniques, intervals, and post-injection care remain unknown. While injected corticosteroids may be more effective than oral NSAIDs for relief in the acute phase of tendon pain, they do not tend to alter long-term outcomes. Some key points to consider include:
- The effects of peritendinous corticosteroid injections are unknown, but they should be used with some caution 1.
- The role of inflammation in tendinopathies is unclear, and corticosteroids may serve only to inhibit healing and reduce the tensile strength of the tissue, predisposing to spontaneous rupture 1.
- There is no evidence-based guideline that supports the use of local corticosteroid injections in tendinopathy, and there may be deleterious effects on the tendon when they are injected into the tendon substance 1. Therefore, alternative methods such as physical therapy programs focusing on passive and active range of motion exercises should be considered to improve long-term outcomes by maintaining the mobility gained during surgical release.
From the Research
Steroid Injection After Adhesive Capsulitis Release Surgery
- The effectiveness of steroid injections after adhesive capsulitis release surgery is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that corticosteroid injections can provide faster pain relief and earlier improvement of shoulder function and motion compared to oral NSAIDs or placebo in patients with adhesive capsulitis 3, 6.
- The optimal dose of intra-articular corticosteroids for adhesive capsulitis is still unclear, with some studies suggesting that low-dose (20 mg) and high-dose (40 mg) corticosteroid injections have similar efficacy 4, 5.
- Corticosteroid injections are generally considered safe, with infrequent and minor side effects 6.
Potential Benefits of Steroid Injections
- Faster pain relief and earlier improvement of shoulder function and motion 3
- Similar efficacy between low-dose and high-dose corticosteroid injections 4, 5
- Safe with infrequent and minor side effects 6
Limitations and Uncertainties
- Lack of direct evidence on the effectiveness of steroid injections after adhesive capsulitis release surgery
- Uncertainty regarding the optimal dose and anatomical site of injections 6