What role do corticosteroid injections play in the management of frozen shoulder, and how effective are they?

Role of corticosteroid injections in frozen shoulder: Intra-articular corticosteroid injections are used as a treatment option for frozen shoulder, particularly in the painful inflammatory phase of the condition. They are recommended when pain persists despite initial conservative measures such as physiotherapy and NSAIDs, or can be offered before starting physiotherapy to facilitate early intensive rehabilitation. These injections should be administered by trained practitioners and are not recommended in the stiffness predominant phase when inflammation has subsided.

Effectiveness: A single corticosteroid injection has been shown to provide short-term improvement in pain, function, and range of movement compared with placebo and possibly manual therapy in people with frozen shoulder of up to one year duration. Intra-articular injections provide better pain relief than subacromial injections. Combining corticosteroid injections with physiotherapy may be more effective than physiotherapy alone. However, the evidence does not clearly define which clinical situations benefit most from steroid injections, and repeated injections carry a risk of tendon damage. Oral corticosteroids are not recommended due to limited and short-term benefit.