[Transdermal nitroglycerin versus corticosteroid infiltration for rotator cuff tendinitis]

Area of Science:

• Orthopedics
• Pain Management
• Pharmacology

Background:

• Rotator cuff tendinitis (RCT) is a common cause of shoulder pain and dysfunction.
• Current treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), but some patients require further intervention.
• Transdermal nitroglycerin (NTG) has been explored as a potential treatment, but its efficacy in RCT is not well-established.

Purpose of the Study:

• To compare the effectiveness and safety of transdermal nitroglycerin (NTG) versus corticosteroid infiltration for treating rotator cuff tendinitis (RCT).
• To evaluate pain reduction and adverse events in patients with RCT receiving either treatment.

Main Methods:

• A randomized controlled study involving 48 patients diagnosed with RCT of less than 6 weeks' duration.
• Patients were randomly assigned to receive either local corticosteroid infiltration (Group A) or a 3-day transdermal NTG patch (Group B).
• Pain was assessed using a visual analog scale, with complete improvement defined as >5-point reduction.

Main Results:

• Corticosteroid infiltration (Group A) resulted in complete improvement in 19 patients and partial improvement in 3, with only 2 treatment failures.
• Transdermal NTG (Group B) showed complete improvement in 5 patients, partial improvement in 5, and 14 treatment failures.
• Adverse events included injection site pain (Group A) and headaches (Group B), with 8 patients abandoning NTG treatment due to headaches.

Conclusions:

• Transdermal nitroglycerin (NTG) is not a viable alternative to corticosteroid infiltration for rotator cuff tendinitis (RCT).
• Corticosteroid infiltration demonstrated superior effectiveness and a better safety profile compared to transdermal NTG in this RCT patient cohort.
• The higher incidence of adverse events, particularly headaches, led to treatment discontinuation in a significant portion of the NTG group.