Corticosteroid Injection for Frozen Shoulder

Evidence Supporting Corticosteroid Injection

The American College of Physicians recommends shoulder corticosteroid injections for patients with shoulder pain lasting more than one month that has failed conservative therapy, particularly when pain intensity exceeds 4/10 or causes functional limitation 3
Repeat injection may be considered if a patient had ≥50% pain relief lasting at least 2 months from the first injection 3
91% of patients show satisfactory improvement in pain and range of motion at 4 weeks following corticosteroid injection 3

Arthrodilation (also called hydrodilatation or distension arthrography) is not mentioned in major shoulder treatment guidelines from the American Heart Association/American Stroke Association, American Academy of Orthopaedic Surgeons, or American College of Physicians 1, 2, 4, 3

Initial conservative management: Physical therapy focusing on stretching and mobilization techniques, especially external rotation and abduction 1
If pain persists >1 month or exceeds 4/10 intensity: Proceed with corticosteroid injection 3
Post-injection management: Avoid overhead pulley exercises 1
Assess response at 4 weeks 3

Short-term pain reduction is well-documented, but long-term pain reduction beyond 12 weeks has not been adequately verified 2
Common adverse events include injection site soreness, transient pain flare, facial flushing, and sweating 3
Joint infection is extremely rare with proper aseptic technique 3