Premium
The effectiveness of hydrodistension and physiotherapy following previously failed conservative management of frozen shoulder in a UK primary care centre
Author(s) -
Rae Glen C.,
Clark Jill,
Wright Matthew,
Chesterton Paul
Publication year - 2020
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1438
Subject(s) - medicine , range of motion , visual analogue scale , conservative management , frozen shoulder , physical therapy , rotator cuff , external rotation , confidence interval , observational study , primary care , surgery , family medicine
Background There is a lack of evidence on the clinical effectiveness of hydrodistension for frozen shoulder following failed conservative management. Methods A total of 90 patients opted for hydrodistension following failed initial treatment which included physiotherapy and at least one corticosteroid injection. Shoulder pain and function were assessed at baseline, and 6, 12 and 24 weeks using the Shoulder Pain Disability Index (SPADI), The Upper Extremity Functional Index (UEFI) and a visual analogue scale (VAS) for pain. Active ranges of motion were assessed at baseline, post‐24 hr and discharge. Results We observed clinically important improvements in pain (VAS −5.5; 90% confidence interval [CI] −6.0 to −5.0; SPADI pain, −20; 90% CI−23 to −17) and function (UEFI 23; 90% CI 19 to 26; SPADI disability, −32; 90% CI −36 to −28) at 6 weeks. These improvements remained clearly substantial at 24 weeks. Active range of motion improved substantially post‐24 hr (flexion 20, 90% CI 18 to 23; lateral rotation 14, 90% CI 12 to 16; abduction 22, 90% CI 19 to 25) and at discharge (flexion 37, 90% CI 33 to 41; lateral rotation 24, 90% CI 21 to 27; abduction 44, 90% CI 38 to 50). Discussion This single‐arm observational study suggests that hydrodistension is an effective treatment of frozen shoulder within a UK primary care setting when standard treatment has failed.