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Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder: A meta-analysis.

Abstract Primary adhesive capsulitis is mainly characterized by spontaneous chronic shoulder pain and the gradual loss of shoulder motion. The main treatment for adhesive capsulitis is a trial of conservative therapies, including analgesia, exercise, physiotherapy, oral nonsteroidal anti-inflammation drugs, and intra-articular corticosteroid injections. Previously, it was reported that intra-articular corticosteroid lead to fast pain relief and improvement of range of motion (ROM). The objective of this study was to determine whether corticosteroid injections would lead to better pain relief and greater improvement in ROM.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28700506
OWN - NLM
STAT- MEDLINE
DA  - 20170712
DCOM- 20170724
LR  - 20170730
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 28
DP  - 2017 Jul
TI  - Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder: A 
      meta-analysis.
PG  - e7529
LID - 10.1097/MD.0000000000007529 [doi]
AB  - BACKGROUND: Primary adhesive capsulitis is mainly characterized by spontaneous
      chronic shoulder pain and the gradual loss of shoulder motion. The main treatment
      for adhesive capsulitis is a trial of conservative therapies, including
      analgesia, exercise, physiotherapy, oral nonsteroidal anti-inflammation drugs,
      and intra-articular corticosteroid injections. Previously, it was reported that
      intra-articular corticosteroid lead to fast pain relief and improvement of range 
      of motion (ROM). The objective of this study was to determine whether
      corticosteroid injections would lead to better pain relief and greater
      improvement in ROM. METHODS: We searched PubMed, Medline, and the Cochrane
      library. We included 5 articles of the 1166 articles identified. Totally
      injection group included 115 patients and placebo group included 110 patients. We
      calculated the weighted mean differences to evaluate the pain relief as the
      primary outcome. We determined the ROM as the secondary outcome. Study quality
      was evaluated using the 12-item scale. We also used the criteria of the Grading
      of Recommendations Assessment, Development and Evaluation to evaluate the quality
      of evidence. RESULTS: In total, 5 studies were included, 4 of which were
      randomized clinical trials, with a sample size of 225 patients with adhesive
      capsulitis of the shoulders. The overall pooled data demonstrated that, compared 
      with placebo as control treatment, intra-articular corticosteroid injections were
      more effective in reducing the pain score at 0 to 8 weeks, but there was no
      difference between the injection group and the control group at 9 to 24 weeks.
      Improvement of ROM in the injection group was greater than that of the control
      group both at 0 to 8 and 9 to 24 weeks. CONCLUSIONS: Intra-articular
      corticosteroid injections were more effective in pain relief in the short term,
      but this pain relief did not sustain in the long term. Intra-articular
      corticosteroid injection resulted in greater improvement in passive ROM both in
      the short and the long terms.
FAU - Wang, Wei
AU  - Wang W
AD  - Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine,
      Zhejiang University, Hangzhou, China.
FAU - Shi, Mingmin
AU  - Shi M
FAU - Zhou, Chenhe
AU  - Zhou C
FAU - Shi, Zhongli
AU  - Shi Z
FAU - Cai, Xunzi
AU  - Cai X
FAU - Lin, Tiao
AU  - Lin T
FAU - Yan, Shigui
AU  - Yan S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Analgesics)
SB  - AIM
SB  - IM
MH  - Adrenal Cortex Hormones/*administration & dosage
MH  - Analgesics/*administration & dosage
MH  - Bursitis/complications/*drug therapy
MH  - Humans
MH  - Injections, Intra-Articular
MH  - Shoulder Joint/*drug effects
MH  - Shoulder Pain/*drug therapy/etiology
PMC - PMC5515778
EDAT- 2017/07/13 06:00
MHDA- 2017/07/25 06:00
CRDT- 2017/07/13 06:00
AID - 10.1097/MD.0000000000007529 [doi]
AID - 00005792-201707140-00044 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(28):e7529. doi: 10.1097/MD.0000000000007529.