Evidence map›Paper›PMID 42340454›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Intra-articular corticosteroid Injection combined with physical therapy versus physical therapy alone for adhesive capsulitis: a meta-analysis of randomized controlled trials.

Marc Boutros, Guy Awad, Akinkunmi Adio, Jad Lawand, Adam Z Khan, Brian W Hill, John G Horneff, Joseph A Abboud

Abstract readMeta-AnalysisComparative StudySystematic Review
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In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Marc BoutrosFaculty of Medicine, Saint Joseph University, Beirut, Lebanon. marceboutros@gmail.com.
Guy AwadFaculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Akinkunmi AdioDepartment of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
Jad LawandThe University of Texas Medical Branch at Galveston, Galveston, USA.
Adam Z KhanDepartment of Orthopaedic Surgery, Southern California Permanente Medical Group, Panorama City, USA.
Brian W HillPalm Beach Orthopaedic Institute, Palm Beach Gardens, USA.
John G HorneffDepartment of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
Joseph A AbboudDivision of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdhesive capsulitis causes shoulder pain and limited motion. Physical therapy (PT) helps but is slow to act. This meta-analysis compares PT alone versus PT plus corticosteroid injections for pain, range of motion (ROM), and function.

methodsA systematic literature search was conducted in PubMed, Scopus, Embase, and Google Scholar for articles published up to April 24, 2026. Eligible studies were randomized controlled trials comparing PT alone to PT combined with intra-articular corticosteroid injections in adults with adhesive capsulitis. Five studies met the inclusion criteria, including 198 patients, with a follow-up duration ranging from 6 to 24 weeks. Primary outcomes included changes in SPADI (Shoulder Pain and Disability Index) and VAS (Visual Analogue Scale) scores from baseline to final follow-up, as well as ROM improvements in flexion, abduction, external rotation, and internal rotation.

resultsPatients receiving combined corticosteroid injection and PT were associated with significantly greater improvements in SPADI scores (MD = 17.52; 95% CI: 5.08 to 29.95; p = 0.006), flexion (MD = 12.99; 95% CI: 5.92 to 20.05; p = 0.0003), abduction (MD = 10.68; 95% CI: 0.53 to 20.84; p = 0.04), and external rotation (MD = 10.35; 95% CI: 6.13 to 14.57; p < 0.0001) compared to PT alone. No significant differences were observed in VAS score reduction (p = 0.41) or internal rotation (p = 0.46).

conclusionThe addition of intra-articular corticosteroid injections to PT provides superior short-term improvements in functional outcomes and ROM for patients with adhesive capsulitis. These results support a combined treatment approach during the early phases of the disease.

Indexed as

Adrenal Cortex HormonesBursitisPhysical Therapy ModalitiesShoulder PainCombined Modality TherapyHumansInjections, Intra-ArticularPain MeasurementRandomized Controlled Trials as TopicRange of Motion, ArticularTreatment OutcomeAdrenal Cortex HormonesAdhesive capsulitisCorticosteroid injectionFrozen shoulderPhysical therapy

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.