What is the role of corticosteroid injections in the treatment of frozen shoulder syndrome (FSS) (adhesive capsulitis)?

Updated: Nov 12, 2020
  • Author: Jefferson R Roberts, MD; Chief Editor: S Ashfaq Hasan, MD  more...
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Answer

A local corticosteroid injection can be used in conjunction with oral NSAIDs or oral corticosteroids. [56, 57]  Studies have shown 20 mg triamcinolone as an optimal dose. [22] Intra-articular or subacromial injections have equal efficacy. [58] Corticosteroid injections provide rapid relief that typically lasts for 6 weeks. Long-term outcomes are similar to those with placebo. [34]

A randomized trial that compared ultrasound (US)-guided injection with blind injection found that by the second week postinjection, improvement in pain intensity, range of motion, and shoulder function score was significantly greater in the US-guided injection group than in the blind injection group. Beyond the third week, however, there were no further significant differences in the improvement between the 2 groups. [59]

Adverse effects must be considered. Triamcinolonone injections can result in Cushing syndrome in patients on protease inhibitors (ritonavir/norvir). Administer injections with caution in patients who have diabetes. [60]


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