The effectiveness of hydrodistension and physiotherapy following previously failed conservative management of Frozen Shoulder in a UK Primary Care Centre

Background: A lack of evidence exists to determine the clinical effectiveness of hydrodistension for Frozen Shoulder following failed conservative management.
Methods: 90 patients opted for hydrodistension following failed initial treatment which included physiotherapy and at least one corticosteroid injection. Shoulder pain and function were assessed at baseline, 6, 12, and 24 weeks using the Shoulder Pain Disability Index (SPADI), The Upper Extremity Functional Index (UEFI), and a Visual Analogue Scale (VAS) pain scale. Active ranges of motion of motion were assessed at baseline, post 24 hours and discharge.
Results: We observed clinically important improvements in pain (VAS -5.5, 90% confidence intervals -6.0 to -5.0; SPADI pain, -20, -23 to -17) and function (UEFI 23 ±19 to 26; SPADI disability, -32, -36 to -28) at 6 weeks. These improvements remained clearly substantial at 24 weeks. Active range-of-motion improved substantially post-24 hours (flexion 20, 18 to 23, lateral rotation 14, 12 to 16, abduction 22, 19 to 25) and at discharge (flexion 37, 33 to 41, lateral rotation 24, 21 to 27 abduction 44, 38 to 50)
Discussion: This single-arm observational study suggests hydrodistension is an effective treatment of frozen shoulder within a UK primary care setting when standard treatment has failed.