Addition of lidocaine injection immediately before physiotherapy for frozen shoulder: a randomized controlled trial

Wei-Chun Hsu; Tao-Liang Wang; Yi-Jia Lin; Lin-Fen Hsieh; Chun-Mei Tsai; Kuang-Hui Huang

doi:10.1371/journal.pone.0118217

Addition of lidocaine injection immediately before physiotherapy for frozen shoulder: a randomized controlled trial

PLoS One. 2015 Feb 25;10(2):e0118217. doi: 10.1371/journal.pone.0118217. eCollection 2015.

Authors

Wei-Chun Hsu¹, Tao-Liang Wang², Yi-Jia Lin³, Lin-Fen Hsieh⁴, Chun-Mei Tsai⁵, Kuang-Hui Huang⁵

Affiliations

¹ Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan, R.O.C; National Defense Medical Center, Taipei, Taiwan, R.O.C; University of Taipei, Taipei, Taiwan, R.O.C.
² Somategrity Clinic, Taipei, Taiwan, R.O.C.
³ Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan, R.O.C; University of Taipei, Taipei, Taiwan, R.O.C.
⁴ Department of Physical Medicine & Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, R.O.C; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C.
⁵ Department of Physical Medicine & Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, R.O.C.

Abstract

The intraarticular injection of lidocaine immediately before a physiotherapy session may relieve pain during the stretching and mobilization of the affected joint in patients with a frozen shoulder, thus enhancing the treatment effect. To compare the effects of intraarticular injection of lidocaine plus physiotherapy to that of physiotherapy alone in the treatment of a frozen shoulder, a prospective randomized controlled trial was conducted in the rehabilitation department of a private teaching hospital. Patients with a frozen shoulder were randomized into the physiotherapy group or the lidocaine injection plus physiotherapy (INJPT) group. The subjects in the INJPT group underwent injection of 3 ml of 1% lidocaine into the affected shoulder 10 to 20 minutes before each physiotherapy session. In each group, the treatment lasted 3 months. The primary outcome measures were the active and passive range of motion of the affected shoulder. The secondary outcome measures were the results of the Shoulder Disability Questionnaire, the Shoulder Pain and Disability Index, and the 36-item Short-Form Health Survey (SF-36). The outcome measures were evaluated before treatment and 1, 2, 3, 4, and 6 months after the start of treatment. The group comparisons showed significantly greater improvement in the INJPT group, mainly in active and passive shoulder range of motion in flexion and external rotation and improvements in pain and disability (P < 0.05); however, no significant group difference was seen in the SF-36 results. The intraarticular injection of lidocaine immediately before a physiotherapy session might be superior to physiotherapy alone in the treatment of a frozen shoulder. Trial registration: ClinicalTrials.gov NCT01817348.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Bursitis / drug therapy
Bursitis / therapy*
Female
Humans
Lidocaine / therapeutic use*
Male
Middle Aged
Physical Therapy Modalities
Radiography
Shoulder / diagnostic imaging
Shoulder / physiopathology

Substances

Lidocaine

Associated data

ClinicalTrials.gov/NCT01817348

Grants and funding

The authors would like to acknowledge the financial support provided by the Shin Kong Wu Ho-Su Memorial Hospital. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.