title: Determination of steroid injection sites using lidocaine test in adhesive capsulitis: A prospective randomized clinical trial.
abstract: BACKGROUND
  To validate the usefulness of subacromial bursa lidocaine for determination of the therapeutic steroid injection site in patients with adhesive capsulitis
  
  
  METHODS
  Ninety-two patients with adhesive capsulitis were randomly divided into the LC (lidocaine test) group (n = 46), in which LC injection was performed at the subacromial bursa prior to therapeutic steroid injection, and GH (glenohumeral) group (n = 46), in which the steroid was injected into the GH. Patients in the LC group received steroid injection at the subacromial bursa or GH according to the result of the LC. Both groups underwent the same exercise protocol. Improvement of the shoulder pain was checked at 2 weeks and 3 months postinjection and expressed on an ordinal scale. Passive range of motion was recorded preinjection, and 2 weeks and 3 months postinjection.
  
  
  RESULTS
  Two weeks postinjection, 37 patients expressed "much improved" and 7 patients expressed "slightly improved" pain levels in the LC group, whereas 18 patients each expressed "much improved" and "slightly improved" pain levels in the GH group, which was significantly different (p < 0.01). This difference was maintained 3 months postinjection (p < 0.01). Passive range of motion in all directions improved significantly 3 months postinjection in both the LC and GH groups (p < 0.01). However, there was no significant difference between the LC and GH groups.
  
  
  CONCLUSIONS
  We found that subacromial lidocaine injection prior to steroid injection resulted in better improvement of pain than conventional GH injection for patients with adhesive capsulitis.
authors: Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Samsung Medical Center, Gangnam-Gu, Irwonro, 50th, Seoul, 135-710, Republic of Korea.
authors: Sang Jun
authors: SJ
authors: Kim
authors: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
authors: Albert O
authors: AO
authors: Gee
authors: Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Samsung Medical Center, Gangnam-Gu, Irwonro, 50th, Seoul, 135-710, Republic of Korea.
authors: Jung Min
authors: JM
authors: Hwang
authors: Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Samsung Medical Center, Gangnam-Gu, Irwonro, 50th, Seoul, 135-710, Republic of Korea.
authors: Jeong Yi
authors: JY
authors: Kwon
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002061:Bursa, Synovial / Q000187:drug effects; D002062:Bursitis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects; D012785:Shoulder Joint / Q000187:drug effects; D020069:Shoulder Pain / Q000188:drug therapy
chemical_list: D000779:Anesthetics, Local; D005938:Glucocorticoids; D008012:Lidocaine
keywords: adhesive capsulitis; glenohumeral joint; lidocaine; subacromial bursa