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Effectiveness of radial extracorporeal shock-wave therapy versus ultrasound- guided low-dose intra-articular steroid injection in improving shoulder pain, function, and range of motion in diabetic patients with shoulder adhesive capsulitis

Journal of Shoulder and Elbow Surgery Jun 21, 2020

El Naggar TEDM, et al. - A 2-parallel-group, active-control, assessor-blinded, randomized trial was sought to compare the effectiveness of radial extracorporeal shock-wave therapy (rESWT) vs. an ultrasound-guided low-dose intra-articular steroid injection in pain reduction and functional improvement in diabetic patients with shoulder adhesive capsulitis (AC). One-hundred three diabetic patients with shoulder AC were assigned randomly to receive either 4 sessions of rESWT, 1 week apart (rESWT group, n = 52), or a single ultrasound-guided low-dose intra-articular steroid injection of 20 mg of triamcinolone acetonide (steroid group, n = 51). The primary endpoint included functional improvement assessed by the Quick Disabilities of the Arm, Shoulder and Hand score. Pain assessed by the visual analog scale score and shoulder range of motion were considered as secondary outcome measures. At short-term follow-up, it was shown that in diabetic patients with shoulder AC, rESWT was superior to a low-dose intra-articular steroid injection in improving function and pain. Thus, It was considered that rESWT is a safe alternative to steroid injections in diabetic patients with shoulder AC.

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