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Platelet-Rich Plasma Versus Corticosteroid Injection in Patients With Primary Frozen Shoulder: A Single-Blinded
Lin-Fen Hsieh1, Yu-Shan Fu2, Ting-An Chen2
1Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, Fu Jen Catholic University, New Taipei City.
Archives of Physical Medicine and Rehabilitation
|February 28, 2026
Summary
Corticosteroid injections combined with physical therapy significantly improved frozen shoulder outcomes compared to platelet-rich plasma or saline injections. All treatments showed improvement, but corticosteroids were superior, especially in the early freezing stage.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Musculoskeletal Rehabilitation
Background:
- Frozen shoulder (adhesive capsulitis) is a debilitating condition characterized by pain and restricted range of motion.
- Current treatment options include physical therapy, corticosteroid injections, and emerging regenerative therapies like platelet-rich plasma.
Purpose of the Study:
- To compare the efficacy of combined glenohumeral joint (GHJ) and subacromial-subdeltoid (SASD) bursa injections of platelet-rich plasma (PRP), corticosteroids (CSs), or normal saline (NS), alongside physical therapy (PT), for treating frozen shoulder.
Main Methods:
- A prospective, single-blinded, randomized controlled trial was conducted with 90 patients diagnosed with primary frozen shoulder.
- Participants were randomized into three groups: PRP + PT, CS + PT, or NS + NS + PT.
- Ultrasound-guided injections targeted both the GHJ and SASD bursa, with outcomes assessed at baseline and 1, 2, 4, and 6 months post-treatment.
Main Results:
- The corticosteroid (CS) group demonstrated statistically significant improvements in the Shoulder Pain and Disability Index (SPADI), Shoulder Disability Questionnaire (SDQ), pain visual analog scale (VAS), active and passive range of motion, patient self-assessment, and SF-36 scores compared to PRP and NS groups.
- These benefits were observed as early as 1 month and sustained through the 6-month follow-up period.
Conclusions:
- Corticosteroid injections, in combination with physical therapy, are more effective than PRP or NS injections for treating frozen shoulder, particularly during the initial freezing stage.
- While CSs showed superior results, all investigated treatment modalities led to significant improvements in patient outcomes.
