Entry By: Tambra Marik, OTR/L, OTD, CHT
Two commonly treated upper quadrant conditions in out-patient rehabilitation are adhesive capsulitis (frozen shoulder) and lateral epicondylosis. Many articles have been published regarding the results of conservative therapy interventions. A variety of injections (prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injection therapies and cortisone) all have some promising results with lateral epicondylosis.
We have learned from Bisset et al (2006) that subjects with lateral epicondylosis have greater pain relief in the short term with cortisone injections, but in the long term greater pain relief with therapy.
Blancard et al (2010) has published the results of cortisone injection versus therapy interventions for subjects with adhesive capsulitis. Although, a completely different pathology than lateral epicondylosis, the results are similar. Subjects with adhesive capsulitis have decreased pain and increased shoulder motion on the short term after cortisone injection, but subjects attending therapy have greater long term results.
This is good news for therapy! However, lets watch for the results for studies where subjects have both therapy interventions and cortisone injections.
How successful are cortisone shots w/patients who have adhesive capsulitis with a history of lupus?
Success of cortisone injection for patients with adhesive capsulitis are really dependent on which stage of the disease they are given. Early stage when it is truly an inflammatory condition is obviously ideal. Success of injections outside of stage one is rare as you are now dealing with physiological changes in the capsule. I feel this is where both the doctor and the therapist really need to educate their patients. If it is truly early stage adhesive capsulitis an injection could be imperative in avoiding a full onset of the disease process, thus improving chances of a full recovery.
Thanks for the post!