This study tests ultrasound-guided injections into the shoulder joint to treat frozen shoulder, a condition that causes pain and stiffness that limits arm movement and daily activities. Researchers are evaluating whether these injections, combined with other treatments, can improve shoulder function and reduce pain in affected patients.
Key Objective: The trial is testing whether ultrasound-guided shoulder injections can effectively reduce pain and improve range of motion in patients with frozen shoulder.
Who to Consider: Patients with frozen shoulder who experience persistent pain and restricted shoulder movement despite conservative treatment should consider enrolling in this trial.
Trial Parameters
Brief Summary
Frozen shoulder (adhesive capsulitis) is characterized by pain and a progressive restriction of both active and passive shoulder range of motion, significantly impairing daily activities and quality of life. This study aims to evaluate the effectiveness of USG-guided shoulder injections, when added to a home-based exercise program, in the conservative management of patients with chronic, painful frozen shoulder. In this prospective randomized study, patients diagnosed with painful frozen shoulder will be included. In addition to a standardized home-based exercise program, patients will receive either USG-guided suprascapular nerve block alone or a combination of suprascapular nerve block and subacromial injection. The effects of these approaches on clinical outcomes will be assessed over a 20-week follow-up period. Primary outcome measures include pain intensity assessed by the Visual Analog Scale (VAS), functional status evaluated by the Shoulder Pain and Disability Index (SPADI), and shoulder range of motion. Secondary outcomes include depression level (Beck Depression Inventory), sleep quality, pain phenotype (nociplastic, neuropathic, or nociceptive), hand grip strength, ultrasonographic findings ( (coracohumeral ligament thickness, subacromial bursa thickness) , and patient satisfaction (subjective impression of improvement). The results of this study are expected to provide evidence on the comparative effectiveness and additional benefits of different shoulder injection approaches when combined with home-based exercise therapy in patients with chronic frozen shoulder.
Eligibility Criteria
Inclusion Criteria: Age between 18 and 75 years and willingness to participate in the study Presence of shoulder pain lasting at least 3 months and a diagnosis of primary frozen shoulder Pain intensity ≥ 4/10 on the Visual Analog Scale (VAS), resistant to medical treatment/analgesics Restriction of ≥30 degrees in at least two planes of shoulder motion (flexion, abduction, or external rotation) \- Exclusion Criteria: * History of shoulder trauma Presence of neurological conditions such as stroke, brachial plexus injury, Parkinson's disease, or cervical spine pathology with or without radiculopathy History of shoulder surgery, shoulder malignancy or tumor, or prior shoulder manipulation Presence of shoulder arthritis, rotator cuff tear, other shoulder injuries, or thoracic outlet syndrome Systemic diseases affecting the shoulder, severe degeneration or trauma (e.g., osteoarthritis, rheumatoid arthritis, labral or articular cartilage injuries), or inflammatory rheumatic diseases Steroid i