2017 ISAKOS Biennial Congress ePoster #2138

 

Corticosteroid Injections Accelerate Pain Relief and Recovery Offunction Compared with Oral Nsaids in Patients with Adhesive Capsulitis a Randomized Controlled Trial

Maximiliano Ranalletta, MD, Buenos Aires, Buenos Aires ARGENTINA
Luciano Rossi, PhD, Buenos Aires ARGENTINA
Santiago Luis Bongiovanni, MD, Buenos Aires ARGENTINA
Gaston Daniel Maignon, MD, Buenos Aires ARGENTINA
Ignacio Tanoira, MD PhD, Buenos Aires ARGENTINA
Italian Hospital , Buenos Aires, ARGENTINA

FDA Status Not Applicable

Summary

Intra-articular corticosteroid injection is a common therapy for adhesive capsulitis, but there is a lack of prospective randomized controlled studies analyzing the efficacy of single injections applied blindly to accelerate improvement in pain and function.

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Abstract

Pupose: To determine if In patients with adhesive capsulitis, a single intra-articular corticosteroid injection without image control applied before the beginning of a physical therapy program will accelerate pain relief and recovery of function compared with oral nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.

Study Design: Randomized controlled trial; Level of evidence, I.

Methods

A total of 74 patients with primary adhesive capsulitis in the freezing stage were randomized to receive either intraarticular injections with betamethasone or oral NSAIDs. Clinical outcome was documented at baseline and after 2, 4, 8, and 12 weeks and comprised a visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) Shoulder Score, the abbreviated Constant-Murley score, and the abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score for function. Passive range of motion was measured with a goniometer.

Results

Patients treated with corticosteroid injections achieved faster pain relief compared with control patients during the first 8 weeks after treatment (P\.001). However, no significant difference in pain was observed among the groups at final follow-up. Likewise, shoulder function and motion improved significantly in both groups at all follow-up points. Shoulder function scores and most motion parameters improved faster in the injection group up to week 8 (P\.001). Again, no significant differences in function
or motion were seen at final follow-up.

Conclusion

In patients with adhesive capsulitis, a single corticosteroid injection applied without image control provides faster pain relief and earlier improvement of shoulder function and motion compared with oral NSAIDs.
Keywords: corticosteroids; adhesive capsulitis; frozen shoulder; intra-articular injections

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