1000 Section - Dose Efficacy in Adhesive Capsulitis: A Double-Blind, Randomized Control Trial

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

YH

Yun Tao Huang, MD

Resident
Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto
Toronto, Ontario, Canada

Co-Author/Coautor(s)

ML

Marc-Antoine Lafrenaye-Dugas, MD

Physiatrist
Université de Sherbrooke
Sherbrooke, Quebec, Canada
HS

Harpreet Sangha, MD, FRCPC

Physician
University Health Network
Toronto, Ontario, Canada
JF

Jordan Farag, MD

Physiatrist, Assistant Professor
Toronto Rehabilitation Institute, University of Toronto
Toronto, Ontario, Canada

Corresponding Author/Autor a quien dirigir la corr(s)

Nimish Mittal, MD, FRCPC (he/him/his)

Associate Professor
University of Toronto
Toronto, Ontario, Canada

Objectives : Adhesive capsulitis affects 2–5% of the population and is the second most common shoulder pathology in outpatient musculoskeletal clinics. Intra-articular corticosteroid injections, especially when combined with hydrodilatation, can accelerate recovery. The anterior ultrasound-guided approach provides superior symptom relief compared to the posterior approach, but the optimal corticosteroid dose remains unclear. This study examines whether 80 mg of methylprednisolone provides greater symptom improvement than 40 mg when used with anterior ultrasound-guided hydrodilatation.

Design:

This is a single-centre, phase II, double-blind randomized controlled trial. Participants were randomized to 40 mg or 80 mg of methylprednisolone (n = 20 per arm). The primary outcome was change in pain and function at three months using the Shoulder Pain and Disability Index (SPADI). Secondary outcomes included Numeric Rating Scale (NRS) pain scores and shoulder range of motion. Between-group differences were assessed using the Mann–Whitney U test.

Results:

Recruitment began in January 2025. As of October 2025, 24 participants have been enrolled (12 per group), with 22 completing four-week and 9 completing three-month follow-ups. Baseline SPADI scores did not differ significantly. At four weeks, both groups showed significant SPADI improvements (40 mg: p = 0.00022, 0.00152; 80 mg: p = 0.00056, 0.02088), with no significant difference between doses. At three months, the 80 mg group showed continued improvement (pain p = 0.01684; disability p = 0.03236). There were insufficient participants in the 40 mg group to evaluate responses at three months. No adverse effects were reported.

Conclusion:

Preliminary findings suggest that 40 mg and 80 mg methylprednisolone doses are effective in providing symptom relief for adhesive capsulitis at four weeks. Although the current sample is underpowered for definitive comparisons, early trends favour the 40 mg dose as potentially preferable given a lower anticipated risk of adverse effects. Final analyses will be presented upon completion of enrolment and follow-up.