Evaluation of Calcitonin Effects on the Treatment of Shoulder Adhesive Capsulitis

Abstract

Backgrounds and Objectives: Adhesive capsulitis, characterized by pain and progressive stiffness of the glenohumeral joint, is a common cause of shoulder pain in patients referred to the outpatient clinic. Calcitonin is a thyroid hormone that provides analgesic effects in painful conditions including complex regional pain syndrome, trauma, vertebral metastasis fractures and etc. Intranasal calcitonin would lead to significant improvement in the treatment of shoulder adhesive capsulitis. Materials and Methods: In a prospective, double blind, randomized, placebo controlled clinical trial study, 64 patients with adhesive capsulitis were divided into 2 groups. The active group received intranasal Calcitonin spray (200 u/day for 6 weeks) and placebo group received placebo spray. Patients of two groups were evaluated before and after intervention, with assessment of shoulder pain, shoulder range of motion and ability in performing daily activities. Results: At 6 weeks, there was greater improvement in shoulder pain, shoulder range of motion and ability in performing daily activities in the calcitonin group than placebo group. In intervention group, 22 (68%) patients experienced improvement while 10 (32%) patients did not experience improvement in their shoulder function. In placebo group, 9 (28%) and 23 (72%) of patients of the placebo group experienced and did not experience improvement of shoulder function. Conclusions: A 6 week course of 200 u/day intranasal calcitonin spray has a significant benefit in shoulder adhesive capsulitis. Considering the noninvasive nature and lack of any significant complications of this treatment, intranasal calcitonin spray associated with physiotherapy and anti-inflammation medicines are recommended for the treatment of shoulder adhesive capsulitis.