A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis.

Abstract

OBJECTIVE:

To assess the effectiveness of intra-articular triamcinolone injection and physiotherapy singly or combined in the treatment of adhesive capsulitis of the shoulder.

METHODS:

Eighty patients with adhesive capsulitis of less than 6 months duration were randomized to one of four groups: Group A, injection of triamcinolone 20 mg and eight sessions of standardized physiotherapy; Group B, injection of triamcinolone 20 mg alone; Group C, placebo injection and eight sessions of standardized physiotherapy; or Group D, placebo injection alone. All subjects were given an identical home exercise programme. Outcome measures were assessed at 6 weeks and 16 weeks. The primary outcome measure was Shoulder Disability Questionnaire (SDQ) score. Secondary outcomes were measurement of pain using a visual analogue scale (VAS), global disability using VAS and range of passive external rotation. A two-way analysis of variance was used to explore the effects of corticosteroid injection and physiotherapy.

RESULTS:

At 6 weeks, the SDQ had improved significantly more in the groups receiving corticosteroid injection (P = 0.004). Physiotherapy improved passive external rotation at 6 weeks (P = 0.02) and corticosteroid injection improved self-assessment of global disability at 6 weeks (P = 0.04). There was no interaction effect between injection and physiotherapy. At 16 weeks, all groups had improved to a similar degree with respect to all outcome measures.

CONCLUSION:

Corticosteroid injection is effective in improving shoulder-related disability, and physiotherapy is effective in improving the range of movement in external rotation 6 weeks after treatment.

• Authors: I Ryans, A Montgomery, R Galway, W G Kernohan, R McKane
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 44 Issue 4 Pg. 529-35 (Apr 2005) ISSN: 1462-0324 [Print] England
• PMID: 15657070 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Glucocorticoids
• Triamcinolone

Topics

• Adult
• Bursitis (drug therapy, physiopathology, rehabilitation)
• Double-Blind Method
• Factor Analysis, Statistical
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Injections, Intra-Articular
• Male
• Middle Aged
• Pain Measurement (methods)
• Physical Therapy Modalities
• Range of Motion, Articular
• Shoulder Joint (physiopathology)
• Single-Blind Method
• Treatment Outcome
• Triamcinolone (therapeutic use)