When Are Steroid Injections Recommended for Frozen Shoulder?

If you’ve been struggling with a stiff, painful shoulder that just won’t seem to move, you might be dealing with a frozen shoulder (also called adhesive capsulitis). It’s a condition I see regularly in my clinic here in Dorset, and one of the most common questions patients ask is whether a steroid injection might help and, importantly, when it’s the right time to have one. The short answer? Timing really matters.

Understanding the Stages of Frozen Shoulder

Frozen shoulder typically develops in three distinct stages, each with its own symptoms and challenges. The first is the freezing stage, where pain and inflammation are at their worst. This is when most people first notice that something isn’t right. Those simple movements, like reaching up or behind your back, suddenly become painful and restricted.

This early stage can last anywhere from six weeks to nine months. During this period, the shoulder capsule becomes inflamed and tight, gradually reducing the joint’s range of motion. After this comes the frozen stage, when the pain may ease slightly but stiffness becomes more noticeable.

Finally, there’s the thawing stage, where movement slowly returns and pain subsides; though this can take months or even years.

Why Does Timing Matter for Steroid Injections?

Steroid injections are most effective when given during the early or freezing phase of frozen shoulder. This is when inflammation is at its peak and pain is most severe. The goal at this stage is to calm the inflammation, reduce discomfort, and prevent the stiffness from worsening.

By reducing pain, these injections often make it easier for patients to start physiotherapy earlier, which can play a crucial role in improving mobility and speeding up recovery. Early intervention can sometimes shorten the overall duration of symptoms, helping you get back to daily activities sooner and with less discomfort.

In my practice, I often recommend performing the injection under ultrasound guidance. This ensures the corticosteroid is delivered precisely into the affected area, maximising its effectiveness and minimising side effects.

What If the Injection Doesn’t Work?

While many people experience significant relief after one or two injections, it’s important to remember that no treatment is one-size-fits-all. If pain and stiffness persist, other treatment options can be explored with your consultant.

These might include guided physiotherapy, hydrodistension (a procedure that gently stretches the joint capsule using fluid), or, in more persistent cases, keyhole (arthroscopic) surgery to release the tight capsule. The best approach depends on your individual symptoms, stage of recovery, and overall health.

That’s why it’s always worth getting a proper assessment and seeking treatment early on, not only to confirm the diagnosis but also to plan the right timing and combination of treatments.

Key Takeaways

Steroid injections can be a valuable part of frozen shoulder treatment, but their success often depends on when they’re given. They’re most effective during the early freezing stage, when inflammation and pain are dominant. By easing pain and improving mobility, they can make physiotherapy more achievable and help prevent long-term stiffness.

If you've noticed that shoulder pain is interfering with your sleep, daily life, or simple movements, don’t wait for it to “just get better”. A timely assessment and treatment plan can make all the difference in your recovery.