Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections
One article on PainSci cites Shah 2007: Complete Guide to Frozen Shoulder
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Adhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of single or multiple injections, but no systematic review has investigated the effects of administering multiple injections.
AIM: To assess the efficacy of treating adhesive capsulitis of the shoulder with multiple corticosteroid injections.
DESIGN OF STUDY: Systematic review.
METHOD: An English language search for randomised controlled trials was conducted from: MEDLINE, EMBASE, CINAHL, PEDro, SIGLE, National Technical Information Service, British National Bibliography, Index of Scientific and Technical Proceedings databases, and the Cochrane Library. Randomised controlled trials were identified from reference lists of review and eligible articles. The studies were assessed using a recognised rating system of methodological trial quality. The conclusions and results of the identified studies, based on their main outcome measures, were then summarised.
RESULTS: Nine randomised controlled trials were identified and four studies were rated as high quality. Three high quality studies showed a beneficial effect for the use of multiple corticosteroid injections with outcome measures of pain reduction, improved function, and increased range of shoulder movement.
CONCLUSION: The evidence suggested that multiple injections were beneficial until 16 weeks from the date of the first injection. Up to three injections were beneficial, with limited evidence that four to six injections were beneficial. No evidence was found to support giving more than six injections.
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- “Management of frozen shoulder: a systematic review and cost-effectiveness analysis,” E Maund, D Craig, S Suekarran, Ar Neilson, K Wright, S Brealey, L Dennis, L Goodchild, N Hanchard, A Rangan, G Richardson, J Robertson, and C McDaid, Health Technol Assess, 2012.
- “Frozen shoulder: A systematic review of therapeutic options,” Harpal Singh Uppal, Jonathan Peter Evans, and Christopher Smith, World J Orthop, 2015.
- “Prognostic factors and therapeutic options for treatment of frozen shoulder: a systematic review,” Walid Eljabu, Hans Michael Klinger, and Marius von Knoch, Archives of Orthopaedic & Trauma Surgery, 2016.
- “Diagnosis and management of adhesive capsulitis,” Robert C Manske and Daniel Prohaska, Current Reviews In Musculoskeletal Medicine, 2008.
- “Frozen shoulder: the effectiveness of conservative and surgical interventions — systematic review,” M M Favejee, B M A Huisstede, and B W Koes, British Journal of Sports Medicine, 2011.
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