OUTCOMES OF SHORT-COURSE ORAL CORTICOSTEROID WITH NONSTEROIDAL ANTI-INFLAMMATORY DRUGS FOR EARLY STAGE OFFROZEN SHOULDER AT KOSHI ZONAL HOSPITAL

  • Yagya RajKhare Department of Orthopedics, Koshi Zonal Hospital, Biratnagar, Nepal
  • Shambhu Sah Department of Orthopedics, Koshi Zonal Hospital, Biratnagar, Nepal
  • Rem Kumar Rai Department of Orthopedics, Koshi Zonal Hospital, Biratnagar, Nepal
  • Nabin Subedi Department of Orthopedics, Koshi Zonal Hospital, Biratnagar, Nepal
  • Anurag Raj Adhikari Department of Physiotherapy, Koshi Zonal Hospital, Biratnagar, Nepal
  • ShivamKarn Department of Physiotherapy, Koshi Zonal Hospital, Biratnagar, Nepal
Keywords: frozen shoulder, corticosteroid, physiotherapy

Abstract

Introduction: Frozen shoulder or adhesive pericapsulitis is a common condition estimated to be afflicting 2-5 % of the general population. It presents with pain and progressive limitation of both active and passive shoulder movement. Numerous treatment options have been described in the literature. Among them, one of the treatment methods commonly used is oral corticosteroid combined with non-steroidal anti-inflammatory drugs (NSAID). This treatment has been found effective in the early stage of frozen shoulder.

Objective: Evaluation of the outcomes in patients with a frozen shoulder after short course oral corticosteroid and NSAIDS.

Methodology: In this cross-sectional study, 50 patients having an early stage of frozen shoulder presenting to the outpatient department of Koshi Zonal Hospital from July to December 2017 were included. We included those patients who had already taken more than two courses of NSAID elsewhere but symptoms did not alleviate. We excluded those patients who were diabetic, pregnant and who had a history of trauma in and around the shoulder, neuromuscular disease, suspected pathology such as a tumor, rotator cuff rupture, infection, and arthritis. Oral steroid and NSAID tablets were given to all the patients under coverage of an oral proton pump inhibitor. The shoulder home exercise program was also instituted. The follow-ups were done on the1st,7th,14thand 21stday in the physiotherapy department to measure range of motion (ROM) and shoulder pain and disability index (SPADI) to evaluate the final outcomes. The data was analyzed by using Microsoft Excel program.

Results: We found the mean age 49.46 years ( range 30-60 years), duration of illness mean 15 weeks (range 10-19 weeks), considerable improvement of ROM from the baseline. Total SPADI scoresDownloaded from Medico Research Chronicles “Outcomes of short-course oral corticosteroid with non-steroidal anti-inflammatory drugs for early stage of frozen shoulder at Koshi Zonal hospital” RajKharel Y. et al., Med. Res. Chron., 2018, 5 (3), 246-251 DOI No. 10.26838/MEDRECH.2018.5.3.412 Medico Research Chronicles, 2018 247 calculated on the1stdaywas mean total 66.7, the 1st week was mean 49.99, 2ndweekwas mean 38.53 and3rd week was mean 26.63 respectively.

Conclusion : The short- course of corticosteroid with NSAID along with shoulder stretch exercises provides rapid pain relief as well as improved ROM and SPADI in a patient with the early-stage frozen shoulder.

Downloads

Download data is not yet available.

References

1. Anton H. Frozen shoulder. Can FamPhys 1993;39:1773–7.
2. Lundberg.The frozen shoulder. Acta Orthop Scand 1969;119(suppl):5–59
3. Manske RC, Prohaska D. Diagnosis, and management of adhesive capsulitis. Current reviews in musculoskeletal medicine. 2008 Dec 1;1(3-4):180-9.
4. Tighe CB, Oakley WS Jr. The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J. 2008; 101:191-195. (Pubmed)
5. Chan HB, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore medical journal. 2017 Dec;58(12):685
6. Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. The current review of adhesive capsulitis. Journal of shoulder and elbow surgery. 2011 Apr 1;20(3):502-14.
7. Van de Laar SM, van der Zwaal P. Management of the frozen shoulder. Orthopedic Research and Reviews. 2014 Oct 7;6:81-90.
8. Ewald A. Adhesive capsulitis: a review. Am Fam Physician. 2011 Feb 15;83(4):417-22.
9. Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomized, double-blind, placebo-controlled trial. Annals of the rheumatic diseases. 2004 Nov 1;63(11):1460-9.
10. Roach KE, Budiman‐Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis & Rheumatology. 1991 Dec 1;4(4):143-9.
11. Kelley MJ, Mcclure PW, Leggin BG. Frozen shoulder: evidence and a proposed model guiding rehabilitation. journal of orthopaedic& sports physical therapy. 2009 Feb;39(2):135-48.
12. Manske RC, Prohaska D. Clinical commentary and literature review: diagnosis, conservative and surgical management of adhesive capsulitis. Shoulder & Elbow. 2010 Oct 1;2(4):238-54.
13. Widiastuti-Samekto M, Sianturi GP. Frozen shoulder syndrome: comparison of oral route corticosteroid and intraarticular corticosteroid injection. Med J
Malaysia. 2004 Aug;59(3):312-6.
14. Canbulat N, Eren I, Atalar AC, Demirhan M, Eren SM, Ucak A. Nonoperative treatment of frozen shoulder: oral glucocorticoids. International Orthopaedics. 2015 Feb 1;39(2):249-54.
15. Lakhani A, Alawadhi K, Jain S, Bhatnagar SM. Comparison of Oral Glucocorticoid and Only Analgesics in the Treatment of Idiopathic Frozen Shoulder. Int J Med Res Prof.2016; 2(5);238-40.
16. Takase K. Oral steroid therapy for frozen shoulder. West Indian Medical Journal. 2010 Dec;59(6):674-9.
How to Cite
1.
Yagya RajKhare, Shambhu Sah, Rem Kumar Rai, Nabin Subedi, Anurag Raj Adhikari, ShivamKarn. OUTCOMES OF SHORT-COURSE ORAL CORTICOSTEROID WITH NONSTEROIDAL ANTI-INFLAMMATORY DRUGS FOR EARLY STAGE OFFROZEN SHOULDER AT KOSHI ZONAL HOSPITAL. Med. res. chronicles [Internet]. 2018Jun.30 [cited 2024Mar.29];5(3):246-51. Available from: https://medrech.com/index.php/medrech/article/view/310
Section
Original Research Article

Most read articles by the same author(s)