Categories
Change Password!
Reset Password!
Corticosteroid injections provide faster, greater, and more sustained clinical improvement than platelet-rich plasma in primary frozen shoulder.
In a randomized controlled trial, corticosteroid injections combined with physical therapy offered earlier, greater, and more durable improvements in pain, disability, shoulder mobility, and patient-reported recovery than platelet-rich plasma (PRP) in people with primary frozen shoulder.
Frozen shoulder is one of the most disabling shoulder disorders, marked by persistent pain and progressively restricted movement that can hamper even simple daily tasks. Although PRP has emerged as a promising regenerative therapy, it remains unclear whether it can outperform the anti-inflammatory benefits of corticosteroids. To address this question, researchers conducted a prospective study comparing PRP, corticosteroid, and placebo injections, all delivered alongside a standardized physical therapy program.
The trial recruited 90 adults with primary frozen shoulder, who were equally randomized into three groups:
Each subject was treated with two ultrasound-guided injections, targeting both subacromial-subdeltoid bursa and glenohumeral joint. Treatment response was checked at baseline and again at 1, 2, 4, and 6 months via validated measures of pain, disability, shoulder range of motion, quality of life, and overall patient perception of recovery. The corticosteroid group emerged as the clear winner. Compared with PRP and saline, these patients experienced greater improvements in shoulder pain and disability (Shoulder Pain and Disability Index; P<0.001) and functional disability (Shoulder Disability Questionnaire; P<0.001).
Pain during activity also declined more substantially (P=0.005), while both active shoulder abduction (P=0.022) and active internal rotation (P=0.036) improved to a greater extent. The benefits extended beyond active movement. Those receiving corticosteroids also demonstrated superior gains in passive abduction (P=0.012) and passive internal rotation (P=0.029), indicating broader restoration of shoulder mobility. They rated their overall recovery more favorably than participants in the other groups (P<0.001), and several domains of the 36-Item Short Form Health Survey (SF-36) also improved significantly more following corticosteroid use.
Perhaps most notably, the therapeutic advantage of corticosteroids appeared within the first month after treatment and remained evident throughout the entire six-month follow-up, suggesting both rapid symptom control and sustained clinical benefit. In summary, corticosteroid injections + physical therapy are the most beneficial injectable strategy for managing primary frozen shoulder, particularly during the painful freezing stage of the disease. While PRP remains a safe option, this trial indicates that it does not surpass the faster and more sustained improvements achieved with corticosteroid therapy.
Archives of Physical Medicine and Rehabilitation
Platelet-Rich Plasma Versus Corticosteroid Injection in Patients With Primary Frozen Shoulder: A Single-Blinded Randomized Controlled Trial
Lin-Fen Hsieh et al.
Comments (0)