Suffering Pain? Study Reveals Physical Therapy is Your Best Pain Relief Option

A Recent Study Suggests Physical Therapy Better than Injections
A recent study highlights the ineffectiveness of injections when used for adhesive capsulitis (frozen shoulder).  In our clinic in Fairfax, we certainly do not discourage the use of injections as we work with many different orthopedists in the area.  There certainly is a benefit for the procedure as it has helped with many of our patients suffering from frozen shoulder.  However, we typically recommend a course of rehab in our office first, prior to any invasive procedure.   Many times we can achieve your goals without injections, and should the procedure be necessary, we would co-treat and combine both rehab and medicine together.  See the study below...

Abstract 

Hsieh L-F, Hsu W-C, Lin Y-J, Chang H-L, Chen C-C, Huang V. Addition of intra-articular hyaluronate injection to physical therapy program produces no extra benefits in patients with adhesive capsulitis of the shoulder: a randomized controlled trial.

Objective

To compare the efficacy of intra-articular hyaluronic acid (HA) injections plus physical therapy (PT) with that of PT alone for the treatment of adhesive capsulitis (AC) of the shoulder.

Design

Prospective, randomized controlled trial.

Setting

Rehabilitation and orthopedics department of a private teaching hospital.

Participants

Patients (N=70) with AC of the shoulder were randomly placed into either of the following treatment groups: group 1, HA injections with PT (HAPT group); or group 2, PT alone (PT group).

Interventions

The patients in group 1 received intra-articular glenohumeral joint injections of HA, 20mg, once per week for 3 consecutive weeks and also participated in a PT program for 3 months. The patients in group 2 received PT alone.

Main Outcome Measures

Active and passive range of motion (ROM) of the affected shoulder, pain, disability, and quality of life.

Results

Both groups experienced improvements in terms of pain, disability, and quality of life after the treatments; furthermore, the active and passive ROM improved linearly with increasing treatment duration. When the groups were compared, no significant group effect was found for any of the outcome measurements.

Conclusions

Intra-articular HA injections did not produce added benefits for patients with AC of the shoulder who were already receiving PT. Thus, the use of intra-articular HA injections for patients with AC of the shoulder should be carefully assessed to reduce unnecessary medical expenditures.