Management of Frozen Shoulder Using Corticosteroid Injection Therapy: An Evaluation of Current Practice among Physical Therapists Providing Injection Therapy in Norway

Abstract

Introduction: Although several interventions have been proposed for frozen shoulder, there is a lack of evidence regarding the best care for the condition, especially concerning corticosteroid treatment and the number of injections used. The treatment strategies and clinical reasoning behind the management among physical therapists providing injection therapy have not previously been evaluated. Methods: A cross-sectional online survey was distributed among 138 Norwegian physical therapists providing injection therapy to evaluate current practice regarding their management of frozen shoulder with corticosteroid injections. Descriptive statistics were used to identify trends in current practice, which were further evaluated in relation to the available literature. Results: The majority of the 32 respondents used multiple ultrasound-guided intra-articular corticosteroid injections for frozen shoulder. None reported to usually achieve satisfactory results following only a single injection, while 87.1 % reported this following 2-3 injections. The use of functional outcome measures as part of the evaluation and decision-making is generally limited among the respondents. Conclusion: Multiple intra-articular corticosteroid injections are currently used in practice in Norway, with the respondents reporting beneficial outcomes following 2-3 injections. However, their efficacy compared to a single injection needs further investigation.

Keywords

• physical therapy modalities
• surveys and questionnaires
• shoulder injection.