Pain relieving effect of short-course, pulse prednisolone in managing frozen shoulder

Adhesive capsulitis or frozen shoulder is a common condition characterized by shoulder pain and stiffness in which conservative methods of treatment such as glucocorticosteroids, anti-inflammatory drugs, and physiotherapy play a significant part. To evaluate the pain relieving effect of short-course pulse prednisolone, this comparison study was planed. Two age and sex-matched groups of patients were studied during three years. Each group consisted of thirty patients suffered from idiopathic Frozen Shoulder. The mean duration from the onset of the disorder to referral to our clinic was five months. Patients' pain on external rotation was qualified using a visual analog scale before and after finishing the treatment. The first group received oral diclofenac (100 mg/day) and physiotherapy. The second group received 500 mg of prednisolone intravenously (i.v.) for three consecutive days at the beginning of treatment in addition to the full treatment regimen of the first group. The pain relieving effects of the two methods of treatment were compared. The mean pain scale for the first group decreased from 7.16 to 4.9 (p < 0.001) and for the second group from 7.10 to 2.96 (p < 0.001) as indicated by Paired sample test. Based on the results of this study, inclusion of 500 mg prednisolone for three days appears to improve the pain-relieving effect of routine conservative treatment of frozen shoulder using NSAIDs and physiotherapy.