Corticosteroid Injections Accelerate Pain Relief and Recovery of Function Compared with Oral NSAIDS in Patients with Adhesive Capsulitis

Abstract

Background: Adhesive capsulitis of the shoulder is a pathological process in which excessive adhesions and fibrous tissue are formed across the glenohumeral joint, resulting in gradually restricted shoulder movements, dysfunction, and pain.
Aim: To analyze the efficacy of corticosteroid injection applied in cases with 1ry adhesive capsulitis and to compare the clinical results achieved with those achieved in cases given oral NSAIDs.
Materials and methods: This meta-analysis was conducted on 4 investigations according to the guidelines by the Cochrane Collaboration reporting followed the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses).
Results: Two studies reported (follow up internal rotation) and all can be used. A significant heterogeneity was observed. Therefore, a random-effect model has been utilized for analysis (I² = 100%, P<0.001). The combined mean difference and 95% CIs was 1.68 (1.47 to 1.89). The combined result demonstrates highly statistically significant difference between groups regarding (follow up internal rotation) (Z = 15.65, P ˂0.001). Two studies reported (follow up external rotation) and all can be used. A non-significant heterogeneity was observed. Therefore, a random-effect model was utilized for analysis (I² = 0%, P=0.89). The combined mean difference and 95 % CIs was 1.30 (0.79 to 1.82). The combined result demonstrates highly statistically significant distinction among groups regarding (monitoring external rotation) (Z = 4.99, P ˂0.001).
Conclusion: Corticosteroid injection performed results in better outcome compared with oral NSAIDs in cases with adhesive capsulitis. More high-quality well-designed trials are required.