Comparison between Oral NSAIDs and Local Steroid Injection  for Treatment of Frozen Shoulder in Diabetic Patients

Dr. Hayyan Fadhil  Abbas; Dr. Ragi Mahssen  Oada; Abbas AbdulWahhab Jumaah  Al-Salih

Authors

Dr. Hayyan Fadhil Abbas M.B.Ch.B., D.A. & I.C.U. (Anesthesia and Intensive Care), Iraqi Ministry of Health, Thi-Qar Health Directorate, Al Hussein Hospital, Thi-Qar, Iraq.
Dr. Ragi Mahssen Oada M.B.Ch.B., D.O.S. \ (Orthopedic Surgeon), Iraqi Ministry of Health, Thi-Qar Health Directorate, Al Hussein Hospital, Thi-Qar, Iraq
Abbas AbdulWahhab Jumaah Al-Salih Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Nahrain University, Kadhimiya, Baghdad, Iraq

Keywords:

Patients with frozen shoulder, Naproxen, Triamcinolone, Risk factors

Abstract

Background: Frozen shoulder is a common musculoskeletal disease which develops during the
soft tissues of the glenohumeral joint are affected, resulting in pain and restricted movement in the
shoulder. Objective: This study was focused on conducting and analyzing clinical outcomes associated
with the comparison between oral NSAIDs and local steroid injections for the treatment of frozen shoulder
in diabetic patients. Patients and methods: We conducted a cross-sectional study of diabetic patients
suffering from frozen shoulder, which included 80 patients who were collected from different hospitals in
Iraq for a period from March 7, 2022, to October 17, 2023. We included two groups. Where the first group
showed diabetes patients who had taken oral NSAIDs, represented by naproxen with 500 mg twice a day,
while the second group showed diabetes patients who had taken steroids, represented by the drug
triamcinolone, which included one injection of 40 mg. The clinical outcomes of the pain score were assessed
by the VAS and SPADI scales. Results: In the group of patients subjected to nonsteroidal antiinflammatory drugs (naproxen) during four months, it was recorded that the extent of flexion in the first
month was mean (104.23) and SD (13.67), in the fourth month it was mean (165.52) and SD (17.84), and the
extent of Abduction (degree) In the first month, the mean and SD were (21.86), in the fourth month, the
mean and SD were (23.54), the average pain in the first month was 5.46 ± 2.63 and the fourth month was
2.01 ± 1.92, while in the group of patients subjected to steroidal anti-inflammatory drugs ( Naproxen)
during four months, the extent of flexion in the first month was mean (105.46) and SD (20.03), in the fourth
month it was mean (168.84) and SD (23.64), the extent of Abduction (degree) in the first month was mean
(92.42) and SD ( 22.1), in the fourth month the mean (175.4) and SD (24.62), the average pain for patients
(triamcinolone) in the first month was 5.87 ± 2.14 and in the fourth month it was 2.23 ± 1.93. Conclusion:
Both oral NSAIDs and local steroid injections are beneficial in relieving frozen shoulder mobility in
diabetic individuals.