To evaluate the clinical efficacy of salmon calcitonin intranasal spray combined with routine treatments in patients with frozen shoulder.

Between January 2016 and March 2017, primary frozen shoulder patients visited the shoulder clinic of Sun Yat-sen Memorial Hospital were evaluated. Patients received at least six weeks analgesia and physiotherapy treatments without significant improvement and had not underwent articular injection were suitable to enter our study. Patients with calcific tendinitis, shoulder joint osteoarthritis or rotator cuff tears, examined by X-ray or MRI, were excluded. The eligible patients might enter the study and choose to use calcitonin intranasal spray or not in their treatments. Patients in the control group received physiotherapy, Celecoxib and single intra-articular injection. Patients in the calcitonin group utilized the same therapeutic scheme as control group and combined the application of nasal calcitonin spray for three months. Patients’ pain measured by visual analog scale (VAS), and shoulder range of motion were evaluated before treatment and at one, two, three and six months after the initial treatment. Constant score and ASES score were assessed regularly. Independent Student’s t test and repeated measures ANOVA were used to compare the statistic differences between the two groups at each time point.

There were 39 patients in the calcitonin group and 37 patients in the control group. At the first month after initial treatment, the VAS score in calcitonin group (2.9±0.7)was significantly lower than control group(4.5±1.0)(t =-8.120, P <0.01). At the second month, the shoulder range of motion in flexion, abduction, external rotation and internal rotation in the calcitonin group were (121.7±18.5)°, (105.8±9.6)°, (30.6±7.7)°, (11.6±3.2)°, respectively. However, the shoulder range of motion in flexion, abduction, external rotation and internal rotation in the control group were (104.9±19.0)°, (91.5±9.2)°, (21.5±6.4)°, (13.9±2.8)°, respectively. Patients received calcitonin achieved much apparent shoulder range of motion improvement than control group (flexion: F=38.855; abduction: F=41.204; external rotation: F=55.341; internal rotation, F=7.963; all P<0.05). At the final follow-up, the Constant score and ASES score in the calcitonin group were nearly normal, better than the control group (Constant score: F=55.161; ASES score: F=70.576, both P<0.05).

Based on the conventional treatments, adding salmon calcitonin intranasal spray can alleviate frozen shoulder patient’s pain faster and restore shoulder function better.