Pericapsular vs Intra-Articular Injection in Adhesive Capsulitis

July 16, 2026 updated by: Bilal Kulaksiz, Istanbul University - Cerrahpasa

Comparison of the Effectiveness of Ultrasound-Guided Pericapsular and Intra-Articular Steroid Injections in Patients Diagnosed With Adhesive Capsulitis

Adhesive capsulitis is a common and disabling shoulder disorder characterized by progressive pain and restricted active and passive range of motion, leading to significant limitations in daily activities and reduced quality of life. Corticosteroid injections are widely used to relieve pain and improve shoulder function; however, the optimal injection site remains a matter of debate. While ultrasound-guided intra-articular injections are considered a standard treatment, ultrasound-guided pericapsular injections have recently emerged as a potential alternative by targeting the inflamed capsular tissues directly.

The primary objective of this study is to compare the clinical effectiveness of ultrasound-guided pericapsular corticosteroid injection with ultrasound-guided intra-articular corticosteroid injection in patients diagnosed with adhesive capsulitis. The study aims to determine whether one injection technique provides superior improvements in pain, shoulder range of motion, functional status, and patient-reported outcomes.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

34

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Fatih
      • Istanbul, Fatih, Turkey (Türkiye), 34093
        • Istanbul University- Cerrahpasa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

-Diagnosis of unilateral adhesive capsulitis, characterized by shoulder pain and restriction of both active and passive range of motion.

Exclusion Criteria:

  • Secondary glenohumeral joint motion limitation due to inflammatory, degenerative, metabolic, or infectious arthritis.
  • History of cerebrovascular accident (stroke).
  • History of fracture involving the affected shoulder.
  • Presence of any neurological deficit affecting the upper extremity.
  • Previous surgery involving the affected shoulder.
  • History of shoulder trauma.
  • Pregnancy or breastfeeding.
  • Known hypersensitivity or allergic reaction to local anesthetics or corticosteroids used in the study.
  • Current use of anticoagulant therapy.
  • Active inflammatory or infectious disease.
  • Active psychiatric disorder.
  • Uncontrolled hypertension.
  • Uncontrolled diabetes mellitus.
  • Uncompensated chronic heart, liver, or renal failure.
  • Presence of vascular or malignant disease affecting the shoulder region.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Intra-articular Group
Participants in the first group (IA group, n = 17) received an ultrasound-guided intra-articular injection. A mixture of 4 mL of 2% lidocaine and 1 mL of betamethasone was administered for the injection procedure.
Drug: Betamethasone
Ultrasound-guided intra-articular injection of 1 mL betamethasone combined with 4 mL of 2% lidocaine.
Other Names:
  • Lidocaine
Drug: Betamethasone
Ultrasound-guided pericapsular injection of 1 mL betamethasone combined with 4 mL of 2% lidocaine.
Other Names:
  • Lidocaine
Active Comparator: Pericapsular Group
Participants in the first group (IA group, n = 17) received an ultrasound-guided pericapsular injection. A mixture of 4 mL of 2% lidocaine and 1 mL of betamethasone was administered for the injection procedure.
Drug: Betamethasone
Ultrasound-guided intra-articular injection of 1 mL betamethasone combined with 4 mL of 2% lidocaine.
Other Names:
  • Lidocaine
Drug: Betamethasone
Ultrasound-guided pericapsular injection of 1 mL betamethasone combined with 4 mL of 2% lidocaine.
Other Names:
  • Lidocaine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Constant-Murley Score
Time Frame: Baseline, Week 1, Week 4, and Month 3
The Constant-Murley Score (CMS) is a validated, clinician-administered instrument used to assess shoulder function. It consists of four domains: pain (15 points), activities of daily living (20 points), range of motion (40 points), and muscle strength (25 points), yielding a total score ranging from 0 to 100. Higher scores indicate better shoulder function and less disability. Changes in the CMS from baseline to each follow-up visit will be used to evaluate treatment effectiveness.
Baseline, Week 1, Week 4, and Month 3
Change in Numeric Rating Scale (NRS) pain score
Time Frame: Baseline,1-Hour, Week 1, Week 4, and Month 3
Pain intensity will be assessed using the Numeric Rating Scale (NRS), an 11-point patient-reported scale ranging from 0 to 10, where 0 indicates no pain and 10 represents the worst pain imaginable. Participants will rate their pain at rest, during the night, and during activity. Changes in NRS scores from baseline to each follow-up visit will be used to evaluate the effectiveness of the interventions in reducing pain.
Baseline,1-Hour, Week 1, Week 4, and Month 3

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Shoulder Disability Questionnaire (SDQ) score
Time Frame: Baseline, Week 1, Week 4, and Month 3
The Shoulder Disability Questionnaire (SDQ) is a validated patient-reported outcome measure used to assess pain-related functional disability in individuals with shoulder disorders. It consists of 16 items evaluating limitations in daily activities experienced during the previous 24 hours. The total score ranges from 0 to 100, with higher scores indicating greater shoulder-related disability. Changes in SDQ scores from baseline to each follow-up visit will be used to assess the effectiveness of the interventions in improving shoulder function and reducing disability.
Baseline, Week 1, Week 4, and Month 3

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 15, 2023

Primary Completion (Actual)

December 20, 2023

Study Completion (Actual)

March 5, 2024

Study Registration Dates

First Submitted

July 12, 2026

First Submitted That Met QC Criteria

July 16, 2026

First Posted (Actual)

July 17, 2026

Study Record Updates

Last Update Posted (Actual)

July 17, 2026

Last Update Submitted That Met QC Criteria

July 16, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E-83045809-604.01.01-539366

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be made available to protect participant confidentiality and privacy.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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