A Prospective Study on Manipulation with Hydrodilatation and Steroid Injection in the Management of Frozen Shoulder

Background: The most common musculoskeletal issue seen in primary care is shoulder pain. Frozen shoulder is characterized by a restricted range of movement and is frequently observed in females and diabetic patients. While a frozen shoulder typically resolves on its own, many patients seek treatment before the 12-month mark to alleviate symptoms. Most individuals can achieve significant improvement with active intervention. Objective: To evaluate the pain severity and range of movements in patients with frozen shoulders using the Constant Shoulder Score (CSS) after manipulation with hydrodilatation and steroid treatment. Methodology: A prospective Observational study was conducted among 42 frozen shoulder patients who attended the outpatient orthopedics department and were admitted to the ward at Dhanalakshmi Srinivasan Medical College and Hospital in Perambalur during March 2023 to August 2024. Information regarding age, sex, duration of symptoms, co-morbidities, and pre- and post-operative grading of Constant Shoulder Score (CSS) findings was recorded. Results: Frozen shoulder was commonly observed in females between 40 and 49 years of age, with the left shoulder most frequently affected. Diabetes mellitus was the most commonly associated risk factor. Following manipulation using the hydrodilatation technique and steroid injection, there was a significant improvement in shoulder pain and range of movements, assessed using Constant Shoulder Score (p=0.000). Conclusion: Frozen shoulder, a condition often seen in older individuals, can greatly impact quality of life. The hydrodilatation technique combined with intra-articular steroid in patients with frozen shoulder showed a decrease in symptoms and improved functional outcomes in range of movements. This treatment is also cost-effective and allows for early mobilization and return to day-to-day activities.