Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial.
OBJECTIVE
To determine whether a short course of prednisolone is superior to placebo for improving pain, function, and range of motion in adhesive capsulitis.


METHODS
Double blind, randomised, placebo controlled trial.


METHODS
Community based rheumatology practice in Australia.


METHODS
50 participants (24 active, 26 placebo); 46 completed the 12 week protocol. Entry criteria were age > or =18 years, pain and stiffness in predominantly one shoulder for > or =3 weeks, and restriction of passive motion by >30 degrees in two or more planes.


METHODS
30 mg oral prednisolone/day for three weeks or placebo.


METHODS
Overall, night, and activity related pain, SPADI, Croft shoulder disability questionnaire, DASH, HAQ, SF-36, participant rated improvement, and range of active motion measured at baseline and at 3, 6, and 12 weeks.


RESULTS
At 3 weeks, there was greater improvement in overall pain in the prednisolone group than in the placebo group (mean (SD) change from baseline, 4.1 (2.3) v 1.4 (2.3); adjusted difference in mean change between the two groups, 2.4 (95% CI, 1.1 to 3.8)). There was also greater improvement in disability, range of active motion, and participant rated improvement (marked or moderate overall improvement in 22/23 v 11/23; RR = 2 (1.3 to 3.1), p = 0.001). At 6 weeks the analysis favoured the prednisolone group for most outcomes but none of the differences was significant. At 12 weeks, the analysis tended to favour the placebo group.


CONCLUSIONS
A three week course of 30 mg prednisolone daily is of significant short term benefit in adhesive capsulitis but benefits are not maintained beyond six weeks.
Monash Department of Clinical Epidemiology, Cabrini Hospital, Melbourne, Australia. rachelle.buchbinder@med.monash.edu.au
R
R
Buchbinder
J L
JL
Hoving
S
S
Green
S
S
Hall
A
A
Forbes
P
P
Nash
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002062:Bursitis / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D011239:Prednisolone / Q000627:therapeutic use*; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011239:Prednisolone