The effectiveness and cost of corticosteroid injection and physiotherapy in the treatment of frozen shoulder-a single-centre service evaluation.
Frozen shoulder is a common condition resulting in pain, stiffness and functional impairment. Symptoms can persist for months or even years if left untreated. Various treatments are available, but a standard care package does not exist and the most cost-effective treatment has not been established. The objective of this study was to conduct a service evaluation of current practice to establish the effectiveness of corticosteroid injection and physiotherapy intervention and the costs associated. A review of all patients with a diagnosis of frozen shoulder who had received a corticosteroid injection and physiotherapy was undertaken for a 12-month period at a single NHS hospital in the UK. Patient-reported outcome measures were analysed and the costs for treatment calculated. Out of the 55 patients, 43 were happy to be discharged following treatment. Ten were referred for a surgical opinion and two were lost to follow-up. The median pain rating significantly reduced from 8 (interquartile range (IQR) 7, 9) to 2 (IQR 0, 3.75) (p < 0.001). Of the patients, 62 % reported a greater than 60 % improvement. On average, patients attended for an initial consultation and four follow-up sessions at a total cost to the NHS of £135. Based on this small service evaluation study, corticosteroid injection administered by an experienced physiotherapist with follow-up physiotherapy appears to be an effective treatment for frozen shoulder.
Derby Hospitals NHS Foundation Trust, Physiotherapy Department, Level 3, London Road Community Hospital, London Road, Derby, DE1 2QY, UK, marcus.bateman@nhs.net.
Marcus
M
Bateman
Stuart
S
McClymont
Sally R
SR
Hinchliffe
D000305:Adrenal Cortex Hormones / Q000191:economics* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002062:Bursitis / Q000188:drug therapy* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities / Q000191:economics*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D006113:United Kingdom
D000305:Adrenal Cortex Hormones