Comparison of corticosteroid injections, physiotherapy, and combination therapy in treatment of frozen shoulder

Objective: Frozen shoulder is a common cause of shoulder pain and disability that refers to a stiffened glenohumeral joint that restricts range of motion significantly. This study was conducted to compare the effect of corticosteroid injection, physiotherapy, and combination therapy in treatment of frozen shoulder. Methodology: This study is a randomized clinical trial on 87 patients from a rheumatology clinic in Sari, Iran, who were suffering from frozen shoulder. The patients were randomized to 1 of the following 3 groups: corticosteroid injection, physiotherapy and combination therapy. Age, sex, duration of disease, level of education, employment, diabetes mellitus, SPADI score and active and passive range of motion were recorded and compared at baseline and after 6 weeks. Results: Eighty seven patients with frozen shoulder were enrolled. The baseline characteristics were similar in the 3 groups, except that external rotation. Six weeks after intervention, patients in combination therapy had more improvement in SPADI and disability scores than physiotherapy (p=0.042 and 0.004). Changing in external rotation (degree) had more improvement in injection group but it was not significant. Conclusion: Combination therapy is more effective than physiotherapy. When used alone, physiotherapy has a limited efficacy in the management of frozen shoulder.