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Tytuł:
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Corticosteroid Injections Accelerate Pain Relief and Recovery of Function Compared With Oral NSAIDs in Patients With Adhesive Capsulitis: A Randomized Controlled Trial.
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Autorzy:
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Ranalletta M; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Rossi LA; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina .
Bongiovanni SL; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Tanoira I; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Elizondo CM; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Maignon GD; Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
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Źródło:
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The American journal of sports medicine [Am J Sports Med] 2016 Feb; Vol. 44 (2), pp. 474-81. Date of Electronic Publication: 2015 Dec 09.
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Typ publikacji:
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Comparative Study; Journal Article; Randomized Controlled Trial
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Język:
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English
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Imprint Name(s):
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Publication: 2004- : Thousand Oaks, CA : Sage Publications
Original Publication: Baltimore, Williams & Wilkins.
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MeSH Terms:
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Adrenal Cortex Hormones/*administration & dosage
Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage
Bursitis/*drug therapy
Administration, Oral ; Aged ; Analgesics/administration & dosage ; Bursitis/physiopathology ; Bursitis/rehabilitation ; Exercise Therapy/methods ; Female ; Humans ; Injections, Intra-Articular ; Male ; Middle Aged ; Musculoskeletal Pain/prevention & control ; Pain Measurement ; Prospective Studies ; Range of Motion, Articular/physiology ; Recovery of Function/drug effects ; Retrospective Studies ; Shoulder Joint/physiology
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Contributed Indexing:
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Keywords: adhesive capsulitis; corticosteroids; frozen shoulder; intra-articular injections
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Substance Nomenclature:
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0 (Adrenal Cortex Hormones)
0 (Analgesics)
0 (Anti-Inflammatory Agents, Non-Steroidal)
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Entry Date(s):
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Date Created: 20151215 Date Completed: 20160919 Latest Revision: 20220331
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Update Code:
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20240104
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DOI:
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10.1177/0363546515616238
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PMID:
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26657263
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Background: 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.
Hypothesis: 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, 1.
Methods: A total of 74 patients with primary adhesive capsulitis in the freezing stage were randomized to receive either intra-articular 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.
(© 2015 The Author(s).)
