Description of published randomised controlled trials of oral corticosteroids for adhesive capsulitis
| Author, year | Sample size | Active intervention | Control intervention | Results |
|---|---|---|---|---|
| Blockey and Wright, 195419 | 32 | Cortisone acetate (200 mg daily for 3 days, then 100 mg daily for 11 days, then dose tapered off in decrements of 12.5 mg every 2 days, total dose = 2.5 g over 4 weeks. If unsatisfactory progress after 4 weeks, manipulation under general anaesthesia; followed by a second four week course of cortisone acetate. | Placebo | No statistical analysis of between-group differences reported, although an earlier clinically important improvement in both pain and range of movement was noted in the oral steroid group: mean pain scores (measured on a 4-point categorical scale converted into an interval scale, where none = 0, slight = 1, moderate = 2, severe = 3) at baseline, 1, 4, and 18 weeks were 1.4, 0.9, 0.5, 0.6 in the steroid group, and 1.4, 1.3, 0.8, 0.5 in the control group; total shoulder abduction was 82°, 103°, 125°, 153° in the steroid group, and 75°, 89°, 106°, 154° in the control group. The number of participants requiring manipulation after four weeks was 6/15 (40%) and 11/16 (68.8%) in the steroid and placebo groups, respectively (RR = 0.58 (0.29 to 1.17). |
| Kessel et al, 198120 | 32 | Prednisolone (15 mg daily for 4 weeks) and manipulation (after 2 weeks of oral steroids) | Manipulation alone | No statistical analysis was done but “dramatic response” to manipulation in 7/12 (58.3%) participants taking oral steroid compared with 5/16 (31.25%) participants taking placebo. Effect of manipulation on final range of movement at 6, 12, and 18 weeks following the procedure also favoured the steroid group but again the differences between groups were not formally analysed. |
| Binder et al, 198621 | 40 | Prednisolone (10 mg daily for four weeks, then 5 mg daily for two weeks) | No treatment | The pattern of improvement in pain at night over 8 weeks showed a significant difference in favour of oral prednisolone with a more rapid initial recovery, although by 5 months the difference between the groups was negligible. Improvement in pain at rest and with movement, range of motion, and a cumulative recovery curve were not significantly different between groups over 8 months. |