Nonoperative management of adhesive capsulitis of the shoulder: Oral cortisone application versus intra-articular cortisone injections

Olaf Lorbach*, Konstantinos Anagnostakos, Cornelia Scherf, Romain Seil, Dieter Kohn, Dietrich Pape

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    115 Citations (Scopus)

    Abstract

    Hypothesis: Oral and intra-articular injections of cortisone will lead to significant improvement and comparable results in the treatment of adhesive capsulitis of the shoulder. Materials and methods: In a prospective randomized evaluation, 40 patients with idiopathic adhesive capsulitis of the shoulder were treated with an oral corticoid treatment regimen or 3 intra-articular injections of corticosteroids. Follow-up was after 4, 8, and 12 weeks, and 6 and 12 months. For the clinical evaluation, the Constant-Murley (CM) score, the Simple Shoulder Test (SST) and visual analog scales (VAS) for pain, function, and satisfaction were used. Results: In the patients treated with oral glucocorticoids, significant improvements were found for the CM score (P < .0001), SST (P=.035), VAS (P < .0001), and range of motion (P < .05) at the 4-week follow-up. The patients treated with an intra-articular glucocorticoid injection series also significantly improved in the CM score (P < .0001), SST (P < .0001), the VAS (P < .0001), and range of motion (P < .05) after 4 weeks. These results were confirmed at all other follow-up visits. Superior results were found for intra-articular injections in range of motion, CM score, SST, and patient satisfaction (P < .05). Differences in the VAS for pain and function were not significant (P > .05). Discussion: The use of cortisone in the treatment of idiopathic shoulder adhesive capsulitis leads to fast pain relief and improves range of motion. Intra-articular injections of glucocorticoids showed superior results in objective shoulder scores, range of motion, and patient satisfaction compared with a short course of oral corticosteroids.

    Original languageEnglish
    Pages (from-to)172-179
    Number of pages8
    JournalJournal of Shoulder and Elbow Surgery
    Volume19
    Issue number2
    DOIs
    Publication statusPublished - Mar 2010

    Keywords

    • Adhesive capsulitis
    • corticosteroids
    • frozen shoulder
    • intra-articular

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