PRP Therapy for Frozen Shoulder: What the Research Shows

Frozen shoulder can take years to resolve on its own. A growing body of research suggests PRP therapy may help reduce pain and improve range of motion in some patients with adhesive capsulitis.

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a painful condition characterized by stiffness and restricted movement in the shoulder joint. This condition often develops gradually, causing significant discomfort and limiting daily activities. While physical therapy and corticosteroid injections are common treatments, recent research suggests PRP therapy may be a helpful option for some patients with adhesive capsulitis, with studies showing improvements in pain and range of motion compared with some control treatments.

How PRP Therapy Works

PRP therapy involves injecting a concentration of a patient’s own platelets into the shoulder joint. These platelets contain growth factors that may help reduce inflammation and support tissue repair. PRP is being studied as a regenerative treatment option across a range of musculoskeletal and pain complaints.

The Progression of Frozen Shoulder

Adhesive capsulitis progresses through three main stages, each lasting several months or even years:

• Freezing Stage: Shoulder pain increases gradually and stiffness sets in, often lasting 6 to 9 months. Activities like lifting, reaching, and even sleeping become increasingly painful.
• Frozen Stage: Lasting 4 to 12 months, the pain may start to subside but shoulder stiffness remains. Range of motion is severely limited.
• Thawing Stage: This final stage may take 6 months to 2 years, as range of motion slowly improves and stiffness gradually decreases. Treatments like PRP can help expedite the healing process.

Clinical Evidence Supporting PRP for Frozen Shoulder

Several studies have demonstrated the efficacy of PRP therapy in reducing pain, improving function, and restoring shoulder mobility in patients with frozen shoulder. A 2024 systematic review and meta-analysis by Zhang et al. of 14 randomized controlled trials involving 1,024 patients found that PRP therapy significantly improved pain scores, shoulder function, and range of motion compared to control groups, including corticosteroid and saline injections.

Nudelman et al. concluded that PRP injections for adhesive capsulitis were at least equivalent to, if not better than, corticosteroid or saline injections, with improved pain, motion, and functional outcomes at 3- to 6-month follow-ups. In a triple-blind RCT, Ünlü et al. showed that PRP injections significantly improved pain, disability, and range of motion, outperforming saline injections. Lin et al. similarly found that PRP significantly improved passive abduction, flexion, external rotation, pain, and disability at 3 and 6 months, with no reported adverse effects.

Why PRP May Be Safer than Corticosteroids

While corticosteroids have traditionally been used to reduce inflammation in frozen shoulder, they carry risks including osteonecrosis and cartilage injury, and may lose effectiveness over time. PRP uses the patient’s own platelets and avoids the tissue-related risks associated with steroids. The 2024 Zhang et al. meta-analysis suggested that PRP may provide more durable pain relief and functional improvement over a longer follow-up period, though individual results vary.

Conclusion

For patients dealing with frozen shoulder, PRP therapy is an option supported by a growing body of clinical research showing improvements in pain, mobility, and function. It is not appropriate for every case, and treatment decisions should be individualized. While more long-term studies are needed to establish definitive guidelines, current evidence supports PRP as a reasonable option to discuss with your provider for selected patients with adhesive capsulitis.