Effectiveness Of Corticosteroid Injections On Adhesive Capsulitis Of Shoulder:a Meta-analysis

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 non-steroidal anti-inflammation drugs (NSAIDs) and intra-articular corticosteroid injections. Previously, it was reported that intra-articular corticosteroid lead to fast pain relief and improvement of ROM (range of motion).Methods We searched PubMed, Medline, and the Cochrane library. We included five of the1166articles identified. We calculated the weighted mean differences to evaluate the pain relief as the primary outcome. We determined the range of motion as the secondary outcome. Study quality was evaluated using the12-items scale. We also used the criteria of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to evaluate the quality of evidence.Results In total, five studies were included, four of which were randomized clinical trials, with a sample size of225patients with adhesive capsulitis of the shoulders. The overall pooled data demonstrated that, compared with control treatment, intra-articular corticosteroid injections were more effective in reducing the pain score at0-8weeks, but there was no difference between the injection group and the control group at9-24weeks. Improvement of ROM in the injection group was greater than that of the control group both at0-8weeks and9-24weeks.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 range of motion both in the short and the long term.