Breaking the Freeze: Intranasal Calcitonin in the Management of Frozen Shoulder

Background: Frozen shoulder is a fairly common multifactorial fibroproliferative disorder characterized by pain and stiffness.Although the etiopathogenesis is not fully understood, it typically starts with inflammation that progresses to fibrosis.There are no evidence-based guidelines on the management of frozen shoulder, and a multimodal treatment strategy is preferred.Calcitonin has been shown to have analgesic, antiinflammatory, and antifibrotic actions, which make it a potential drug for targeted treatment of frozen shoulder.This single-group prospective interventional study evaluated the efficacy of intranasal salmon calcitonin in patients with frozen shoulder.Materials and methodology: A total of 51 patients diagnosed with frozen shoulder, with a symptom duration of less than 12 months, were treated with 200 IU of intranasal calcitonin once daily for 4 weeks, along with regular physiotherapy.They underwent serial evaluation using the Shoulder Pain and Disability Index (SPADI) scoring system at baseline and follow-ups at 2, 4, and 8 weeks.Results: The study included 51 patients with a mean age of 52.43 years (SD = 11.18) and a nearly equal gender distribution (49% female, 51% male).The mean duration of symptoms was 4.24 months (SD = 1.39).There was a statistically significant (p < 0.0001) reduction in both disability and pain and a statistically significant (p < 0.0001) improvement in function with four weeks of intranasal salmon calcitonin therapy during short-term follow-up.No significant complications were reported during the study duration. Conclusion:With the growing need for a safer alternative to non-steroidal anti-inflammatory drugs (NSAIDs) in the at-risk population that suffers from Frozen Shoulder, Calcitonin appears to be a safe and effective treatment option for frozen shoulder in conjunction with physical therapy.Level of evidence: Level IV.