Physiotherapy Shows Better Functional Recovery Than Steroid Injection in Short-Term Frozen Shoulder Trial
Randomized clinical trial finds both treatments reduce pain and improve movement, but multimodal physiotherapy delivers stronger gains in shoulder function and internal rotation.
A newly published randomized clinical trial has found that both intra-articular corticosteroid injections (IAI) and multimodal physiotherapy (MPT), when combined with a home exercise program, significantly improve pain, disability and shoulder mobility in patients with frozen shoulder over the short term. However, patients receiving multimodal physiotherapy experienced greater improvements in overall shoulder function and internal rotation.
The study, published in Scientific Reports, compared the effectiveness of a corticosteroid injection directly into the shoulder joint with a structured multimodal physiotherapy program. Researchers evaluated pain intensity, shoulder disability, range of motion and patient-reported recovery during short-term follow-up.
Both treatment groups reported meaningful reductions in pain and improvements in daily function. However, the physiotherapy group demonstrated a stronger overall treatment effect, particularly in functional outcomes and restoration of shoulder internal rotation. These improvements suggest that a comprehensive rehabilitation program may offer added benefits beyond pain relief alone.
Despite these findings, researchers noted that differences between the two groups were not statistically significant for several major outcomes, including pain scores, total Shoulder Pain and Disability Index (SPADI), external rotation, abduction and scaption range of motion. This indicates that both treatment options remain clinically effective for managing frozen shoulder in the short term.
The investigators cautioned that the trial involved a relatively small number of participants, limiting the ability to declare one treatment definitively superior. They emphasized the need for larger randomized studies to confirm whether multimodal physiotherapy consistently provides better long-term outcomes than corticosteroid injections.
Frozen shoulder, or adhesive capsulitis, affects up to 5% of the population and is characterized by progressive pain, stiffness and restricted shoulder movement. It is especially common among people aged 40–65 years and those with diabetes or thyroid disorders. Early diagnosis and timely treatment are considered essential to restore mobility and reduce long-term disability.
Experts say treatment should be individualized based on the stage of the disease, pain severity and patient preferences. While corticosteroid injections may provide faster pain relief for some patients, structured physiotherapy remains a cornerstone of recovery by improving joint mobility, muscle strength and long-term shoulder function. The latest trial reinforces the importance of supervised rehabilitation as a key component of frozen shoulder management.
