Emerging treatments

Sodium hyaluronate/hyaluronic acid injection

There is some limited evidence that supports the use of sodium hyaluronate injections for pain relief.[70] One systematic review found similar improvements in clinical outcome and range of motion when hyaluronic acid injections were compared with intra-articular corticosteroid injections.[71]

Continuous passive motion

May provide a benefit in pain relief early in the disease process.[72][73]

Bee venom acupuncture

One randomised controlled trial (RCT) concluded that the use of bee venom acupuncture (BVA) in combination with physiotherapy might provide better functional improvement and pain reduction than physiotherapy alone at 12 weeks post intervention.[74] A retrospective 1-year follow-up analysis of this RCT reported that the beneficial effects were still present 1 year after treatment, and suggests that BVA may help improve long-term quality of life in patients with adhesive capsulitis.[75]

Extracorporeal shockwave therapy (ESWT)

Has shown promise as an alternative treatment to oral corticosteroids and low-dose intra-articular corticosteroid injections, with short-term benefits of pain relief and improved range of motion.[76][77] ESWT has been successfully used to treat other fibrotic diseases such as Dupuytren's contracture and Peyronie's disease, which have similar pathological processes to adhesive capsulitis. 

Pulsed radiofrequency stimulation

Pulsed radiofrequency stimulation of the suprascapular nerve (guided by ultrasound) combined with physiotherapy has shown promise in one randomised controlled trial (RCT). This study found better and faster relief from pain, reduced disability, and improved passive range of motion compared with physiotherapy alone for up to 12 weeks.[78] A double-blind RCT is in progress.[79]

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