High-dose short-course oral corticosteroid protocol for treatment of primary frozen shoulder: a retrospective cohort study

Abstract

Objective To evaluate the effect of high-dose prednisolone on the functional outcome of patients with early-stage primary frozen shoulder. Methods Eighteen patients treated with oral prednisolone at an initial dose of 1 mg/kg/day for primary frozen shoulder were retrospectively evaluated. The patients’ range of motion, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant–Murley score, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale score were recorded at baseline and at 4 weeks and 6 months after treatment. Results Rapid recovery of shoulder motion was noted at 4 weeks with the exception of abduction, which was maintained at 6 months. Significant improvement in pain perception and the Constant–Murley score was evident at 4 weeks and extended to 6 months. The DASH and ASES scores did not show significant improvement in the first 4 weeks but were significantly improved at 6 months. Conclusion High-dose oral prednisolone treatment provides rapid symptom resolution that persists long after drug discontinuation. The early treatment period is characterized by marked reduction in pain and rapid recovery of shoulder motion. Improvements in functional outcomes and disability indices tend to be more subtle in the early period but significantly improve during late treatment.

A retrospective study of ultrasound-guided intervention for frozen shoulder in the frozen stage

“…However, in the frozen stage, CHL thickness correlates negatively with the Er and Ir ranges of the shoulder ( 14 ), and FS patients with thickening of the CHL do not achieve good improvement of shoulder ROM using this method alone ( 24 ). Many studies have shown that steroid drugs can effectively control pain associated with FS ( 25 ), but these drugs are relatively short acting ( 26 , 27 ). Traditional or single US-guided injection therapy is not the best method to treat FS, especially for patients in the frozen stage.…”