Frozen shoulder initial management and when are corticosteroid injections considered?

• A. Start with physical therapy and NSAIDs; corticosteroid injections for persistent pain or limited ROM.
• B. Immediate surgical release.
• C. Rely solely on rest.
• D. Use opioid analgesics only.

Answer: (A)

Nonoperative management is first-line for frozen shoulder, focusing on preserving and gradually restoring range of motion while controlling pain. Begin with a structured physical therapy program that emphasizes gentle, progressive stretching and ROM exercises, paired with analgesia such as NSAIDs to help with pain and inflammation. Corticosteroid injections are considered when pain and stiffness persist after initial therapy, because the steroids can reduce intra-articular inflammation and improve ROM enough to allow more effective rehabilitation. They’re typically used in the early to mid stages when pain and motion loss are limiting function. If substantial symptoms and limited ROM persist after several months of nonoperative treatment, surgical options may be explored; rest or using opioids alone do not address the underlying stiffness and are not appropriate as initial management.