A Cochrane review [Abstract] 1 included 5 small studies with a total of 179 subjects. Comparisons included oral steroids vs. placebo (2 trials), oral steroids vs. no treatment (1 trial), oral vs. intra-articular steroids (1 trial) and manipulation under anaesthesia and intraarticular steroid injection with or without oral steroids (1 trial). Only one trial was of high quality.
One trial reported significant short-term benefits of oral steroids versus placebo: 48% more participants reported success (RR = 2 (95% CI 1.3 to 3.1, NNT=2); overall improvement in pain 2.7 (95% CI 1.4 to 4.0) on a 0 to 10 point scale; total shoulder abduction increased by 23.3 degrees (95% CI 11.3 to 35.3); Shoulder Pain and Disability Index (SPADI) score improved by 18.1 (95% CI 7.6 to 28.6) on a 0 to 100 point scale. Benefits were not maintained at 6 weeks. A second trial reported no significant differences between oral steroid and placebo in pain or range of movement but it suggested improvement occurred earlier in the steroid treated group. A third trial reported that oral steroids provided a more rapid initial improvement in pain compared to no treatment but negligible differences by five months.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by inconsistency (variability in results across studies).
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