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Combined physical therapy and intra-articular corticosteroid injections improve range of motion in adhesive capsulitisCombining physical therapy and steroid injections improves frozen shoulder mobility

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Key Takeaway
Consider combining physical therapy with intra-articular corticosteroids for improved ROM in adhesive capsulitis.

This meta-analysis evaluated the efficacy of combining physical therapy with intra-articular corticosteroid injections versus physical therapy alone in 198 adults with adhesive capsulitis. The analysis focused on functional scores, pain levels, and range of motion (ROM) over a follow-up period of 6 to 24 weeks.

The meta-analysis found that the combined intervention group achieved significantly greater improvements in SPADI scores (MD = 17.52; 95% CI: 5.08 to 29.95; p = 0.006) and flexion (MD = 12.99; 95% CI: 5.92 to 20.05; p = 0.0003). Additionally, the combined group showed significantly greater improvements in abduction (MD = 10.68; 95% CI: 0.53 to 20.84; p = 0.04) and external rotation (MD = 10.35; 95% CI: 6.13 to 14.57; p < 0.0001).

In contrast, no significant differences were found between the combined group and the physical therapy alone group regarding VAS score reduction (p = 0.41) or internal rotation (p = 0.46). The findings suggest that while adding corticosteroid injections may enhance specific ROM metrics and functional scores in the short term, it does not appear to impact pain scores or internal rotation more than physical therapy alone within the studied timeframe.

How this fits prior evidence

This meta-analysis extends previous evidence regarding adhesive capsulitis management. It specifically builds upon findings that a suprascapular nerve block added to steroid injection shows early pain benefit but no long-term functional benefit over intra-articular steroids (IAS) alone. This current study confirms that adding corticosteroid injections to physical therapy provides superior short-term improvements in functional outcomes and specific range of motion measures like flexion, abduction, and external rotation compared to physical therapy alone.

Living with a frozen shoulder, known as adhesive capsulitis, can make simple daily movements like reaching for a shelf or dressing yourself feel impossible. While many people turn to physical therapy to regain motion, some find they need extra help to manage the discomfort and stiffness of the joint.

A review of data from 198 adults showed that combining physical therapy with corticosteroid injections—a steroid medicine injected directly into the joint—led to better results than doing physical therapy alone. Patients in the combined group saw significantly greater improvements in their overall function scores and their ability to move the arm in several directions, including flexion and abduction.

While both groups showed progress, the combination was more effective for improving range of motion in the short term. It is important to note that while this approach helps with movement and function, it did not show a significant difference in pain scores or internal rotation compared to therapy alone. These findings focus on short-term improvements, so talk to your doctor about how these options might fit into your specific recovery plan.

What this means for you:
Adding steroid injections to physical therapy helps patients with frozen shoulder regain more movement and function.

Common questions

Does adding a steroid injection help my frozen shoulder?

Yes, combining physical therapy with a corticosteroid injection (a steroid medicine) into the joint showed significantly better results for movement and function than doing physical therapy alone. This combination helped patients improve their ability to move their arms in several directions over a period of 6 to 24 weeks.

Will the injection help my pain more than just therapy?

While the combination of treatment showed better results for movement and function, there was no significant difference in pain scores between those who received only physical therapy and those who received both physical therapy and a corticosteroid injection.

How much improvement can I expect with combined treatment?

Patients receiving both treatments showed significantly greater improvements in flexion, abduction, and external rotation compared to those doing only physical therapy. These results are specifically noted as short-term improvements for your ability to move the joint.

Study Details

Study typeMeta analysis
Sample sizen = 198
EvidenceLevel 1
Follow-up5.5 mo
PublishedJun 2026
View Original Abstract ↓
BACKGROUND: Adhesive capsulitis causes shoulder pain and limited motion. Physical therapy (PT) helps but is slow to act. This meta-analysis compares PT alone versus PT plus corticosteroid injections for pain, range of motion (ROM), and function. METHODS: A systematic literature search was conducted in PubMed, Scopus, Embase, and Google Scholar for articles published up to April 24, 2026. Eligible studies were randomized controlled trials comparing PT alone to PT combined with intra-articular corticosteroid injections in adults with adhesive capsulitis. Five studies met the inclusion criteria, including 198 patients, with a follow-up duration ranging from 6 to 24 weeks. Primary outcomes included changes in SPADI (Shoulder Pain and Disability Index) and VAS (Visual Analogue Scale) scores from baseline to final follow-up, as well as ROM improvements in flexion, abduction, external rotation, and internal rotation. RESULTS: Patients receiving combined corticosteroid injection and PT were associated with significantly greater improvements in SPADI scores (MD = 17.52; 95% CI: 5.08 to 29.95; p = 0.006), flexion (MD = 12.99; 95% CI: 5.92 to 20.05; p = 0.0003), abduction (MD = 10.68; 95% CI: 0.53 to 20.84; p = 0.04), and external rotation (MD = 10.35; 95% CI: 6.13 to 14.57; p < 0.0001) compared to PT alone. No significant differences were observed in VAS score reduction (p = 0.41) or internal rotation (p = 0.46). CONCLUSION: The addition of intra-articular corticosteroid injections to PT provides superior short-term improvements in functional outcomes and ROM for patients with adhesive capsulitis. These results support a combined treatment approach during the early phases of the disease.
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