Clinical outcomes of intra-articular corticosteroid injection vs. multimodal physiotherapy in patients with frozen shoulder in short term: a randomized clinical trial

This study aimed to compare the short-term effects of multimodal physiotherapy (MPT) with intra-articular corticosteroid injection (IAI) on pain, disability, effectiveness of treatment, and passive range of motion in patients with frozen shoulder. Randomized Controlled Trial. University Hospital. Patients diagnosed with frozen shoulder with at least 50% passive range of motion (PROM) limitation. Forty-eight patients were allocated into two groups: Group A: MPT and Group B: IAI. After allocation, all patients received a prescription of a comprehensive home exercise pamphlet (HEP) and were instructed to perform them for six weeks. Pain ((visual analogue scale (VAS), shoulder pain and disability index (SPADI)), disability (SPADI), and PROM for abduction, external rotation, and scaption were recorded at the baseline and 6 weeks after randomization. The effectiveness of treatment (global rating scale (GRC)) was recorded 6 weeks after randomization. Pain (VAS) and (SPADI), disability (SPADI), and passive range of motion (PROM) significantly improved after both treatments (p < 001). The effect size of MPT was larger than IAI for all outcomes. Notably, significant positive differences were observed in internal rotation PROM (p = 0.036, effect size (ES) = 0.627) and the disability section of the GRC scale (p = 0.005), indicating that MPT was more effective. However, in VAS, SPADI (total), GRC (pain), external rotation, abduction, and scaption PROM, the difference between the treatment groups was not statistically significant. MPT and IAI are both effective short-term interventions. The stronger effect and specific superior outcomes of MPT are promising, but the limited sample size precludes definitive conclusions regarding superiority. Larger trials are warranted to confirm these findings.