Costison step therapye

Cortisone has proven effective as a medication in the treatment or support of other treatment methods for various shoulder disorders. Study results and our own experience show significant relief of symptoms, particularly in cases of frozen shoulder.

Cortisone injections often provide relief from symptoms. However, such cortisone injections are not without risk and should only be performed rarely.

Oral cortisone administration (taking tablets) carries a significantly lower risk.

A study was published several years ago recommending a step-down cortisone therapy with tablets for the treatment of frozen shoulder. We have been using this step-down cortisone regimen to treat frozen shoulder for years. This treatment almost always results in significant pain relief. Patients report, in particular, that they can sleep at night again, which significantly improves their quality of life. They also often report improved mobility.

After the positive effect of cortisone was also reported at the San Diego Shoulder Course in 2018, we modified our previous scheme.

If there are no contraindications to cortisone and the patient is suffering accordingly, I recommend this modified cortisone step-by-step scheme:

Starting with approximately 0.5 mg per kg of body weight, prednisolone is taken in the morning for 5 days, after which the dose is reduced by 0.125 mg of prednisolone per kg of body weight every 5 days.

Prescriptions include 20 mg prednisolone tablets, which can be divided into quarters. Individual doses must be rounded up or down. At the end of this regimen, I administer a dose of 5 mg prednisolone for 20 days before discontinuing it completely.

Whether such treatment is suitable for you must be determined by a doctor. In particular, any contraindications to cortisone administration must be clarified.