title: Corticosteroid Injections Accelerate Pain Relief and Recovery of Function Compared With Oral NSAIDs in Patients With Adhesive Capsulitis: A Randomized Controlled Trial.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Ranalletta
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina luciano.rossi@hospitalitaliano.org.ar.
authors.forename: Luciano A
authors.initials: LA
authors.lastname: Rossi
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Santiago L
authors.initials: SL
authors.lastname: Bongiovanni
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Tanoira
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Elizondo
authors.affiliation: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Gastón D
authors.initials: GD
authors.lastname: Maignon
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002062:Bursitis / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000517:prevention & control; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000187:drug effects; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000502:physiology
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: adhesive capsulitis; corticosteroids; frozen shoulder; intra-articular injections