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The relationship between central sensitization levels and treatment outcomes in patients with frozen shoulder undergoing intra-articular injection

anesthesiology-and-pain-management
orthopedics

Abstract

Background: Data on the effect of central sensitization (CS) on intra-articular injection outcomes in frozen shoulder (FS) remains unavailable.

Objective: To investigate the relationship between CS levels and treatment outcomes in patients who underwent ultrasound-guided intra-articular injection for FS.

Methods: In this retrospective study, 87 patients with FS who underwent intra-articular injection were included. Participants were classified into two groups based on the presence of CS. All patients were evaluated both at baseline and four weeks after the injection in terms of daytime, nighttime, and during the injection procedure pain intensity; pressure pain threshold (PPT) around the shoulder on both painful and non-painful sides; and shoulder-related pain and disability using the Shoulder Pain and Disability Index (SPADI).

Results: 47 patients were included in the final analysis. 21 patients were classified as with CS and 26 patients as not having CS. In both groups, significant improvements were observed at the four-week follow-up in VAS daytime and nighttime pain scores, PPT values, and SPADI scores. Improvements in VAS daytime and nighttime pain scores and SPADI scores were significantly less in the CS group. Changes in PPT values were similar between the 2 groups. The number of female patients and the pain intensity experienced during injection were significantly higher in the CS group. In both groups, the baseline PPT values ​​of the deltoid, trapezius, supraspinatus, and forearm muscles on the painful side were significantly lower than on the pain-free side.

Conclusion: Patients with CS showed less improvement in pain and disability after injection.

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