RT Journal Article
SR Electronic
T1 Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1460
OP 1469
DO 10.1136/ard.2003.018218
VO 63
IS 11
A1 R Buchbinder
A1 J L Hoving
A1 S Green
A1 S Hall
A1 A Forbes
A1 P Nash
YR 2004
UL http://ard.bmj.com/content/63/11/1460.abstract
AB Objective: To determine whether a short course of prednisolone is superior to placebo for improving pain, function, and range of motion in adhesive capsulitis. Design: Double blind, randomised, placebo controlled trial. Setting: Community based rheumatology practice in Australia. Participants: 50 participants (24 active, 26 placebo); 46 completed the 12 week protocol. Entry criteria were age ⩾18 years, pain and stiffness in predominantly one shoulder for ⩾3 weeks, and restriction of passive motion by >30° in two or more planes. Interventions: 30 mg oral prednisolone/day for three weeks or placebo. Main outcome measures: 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.