Frozen shoulder, or adhesive capsulitis, is a condition that causes significant pain and stiffness in the shoulder joint. This progressive disorder can severely limit arm movement, impacting daily activities. While the condition can resolve on its own over time, often spanning several months to a few years, steroid injections are a common treatment option to alleviate symptoms and aid recovery.
Understanding Frozen Shoulder
Frozen shoulder occurs when the connective tissue surrounding the shoulder joint, called the joint capsule, becomes thick, inflamed, and tight. This thickening and tightening, sometimes accompanied by the development of scar tissue (adhesions) and a reduction in lubricating synovial fluid, restricts the shoulder’s ability to move freely. The condition typically progresses through three phases: the “freezing” phase marked by increasing pain and stiffness, the “frozen” phase where pain might lessen but stiffness is pronounced, and the “thawing” phase during which movement slowly improves.
The Steroid Injection for Frozen Shoulder
A steroid injection for frozen shoulder involves corticosteroids, such as triamcinolone or cortisone, directly into the shoulder joint capsule. These anti-inflammatory medications reduce the inflammation within the joint, alleviating pain and improving range of motion. The procedure often includes a local anesthetic, like lidocaine, mixed with the corticosteroid to provide immediate, temporary pain relief. Imaging guidance ensures precise delivery of the medication within the joint.
Timeline of Relief and Expected Duration
Relief from a steroid injection for frozen shoulder varies. Patients may experience immediate, temporary pain reduction from the local anesthetic. The corticosteroid’s anti-inflammatory effects typically begin within 3 to 5 days, with peak relief commonly reported around two weeks post-injection, and this improvement can continue to progress.
The duration of pain relief and improved mobility from a single steroid injection generally lasts for several weeks to a few months. While injections provide short-term benefits in pain reduction and movement, they do not offer a permanent cure for the underlying condition. The relief provided is often considered a “window of opportunity” to facilitate more effective physical therapy.
Maximizing Recovery and Next Steps
After a steroid injection, rest the shoulder for a few days before gradually resuming activity. The injection’s pain-reducing effects create an optimal period for engaging in physical therapy to restore full shoulder movement. Physical therapy sessions, which may include stretching and range-of-motion exercises, should begin within two weeks of the injection for maximum recovery.
If the initial injection does not provide sufficient relief or if symptoms return, repeat injections might be considered, though their frequency is typically limited due to potential side effects. Doctors typically limit these injections to every six weeks or a maximum of four times a year. If conservative measures, including injections and physical therapy, prove ineffective, other treatment options such as hydrodilatation or surgical interventions may be explored.