Intra-Articular along with Subacromial Corticosteroid Injection in Diabetic Patients with Adhesive Capsulitis

Background: To compare intra-articular plus subacromial corticosteroid injection with a single intra-articular injection in diabetics with adhesive capsulitis. Materials and Methods: A total of fifty-four diabetic patients were randomized into corticosteroid injection in both intra-articular and subacromial sites (group A) and one intra-articular injection (group B). Pain by a visual analog scale (VAS), shoulder range of motion, and functional state by the American Shoulder and Elbow Score was assessed before injection, and at follow-up months. Results: The pain VAS scores of group A were considerably lower than group B at the first-month follow-up visit (P=0.01). The range of motion in forward-elevation and internal rotation at three-month follow-up visits was significantly higher in group A than in group B (P=0.035, P=0.04, respectively). No notable differences in the range of motion in forward-elevation, internal rotation, and external rotation between groups at the final follow-up visit were seen. Though a significant difference in the ASES between groups at the third-month follow-up visit (P=0.03), the ASES score at the final sixth-month follow-up was similar in both groups (P=0.7). Conclusion: In diabetic adhesive capsulitis of the shoulder, subacromial combined with intra-articular steroid injections has superior subjective outcomes compared to single intra-articular corticosteroid injection.