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Shoulder Steroid Injections for

Frozen Shoulder in London

The cost to treat a frozen shoulder is £270. This includes: Assessment and ultrasound scan, Prescription, injection and follow up report detailing the procedure.

We have 2 procedures available to treat a frozen shoulder. 1) Intra-articular injection of a corticosteroid. 2) Intra-articular injection of a corticosteroid and a hydrodistension which includes stretching of the shoulder joint using saline at the same time as the injection procedure. We can discuss these procedures with you at the time of the appointment and select the best treatment approach for you.

Frozen Shoulder
Adhesive capsulitis, often referred to as frozen shoulder, is a condition which causes pain and stiffness in the shoulder joint due to the capsule that encloses the shoulder joint becoming thicker, contracted and tighter than it should be.

It can start insidiously or after you have had trauma to the shoulder like a fracture or after surgery.

Symptoms of Frozen Shoulder

  • A dull or aching pain in your shoulder, which tends to be worse at night or when you move your shoulder joint.
  • Stiffness around your shoulder joint that may stop you from moving your shoulder normally. This can make it difficult to do everyday tasks such as driving or dressing yourself.

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The 3 stages of a frozen shoulder

1. Freezing Phase

Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption.

Can last from 2 – 9 months

2. Frozen Phase

Pain starts to subside and progressive loss of shoulder range of movement.  Pain only with extremes of movement.

Can last for about 12 months

3. Thawing Phase

Spontaneous, progressive improvement in range of movement.

May last up to 3 years

What causes it?

Onset of this pathology is usually idiopathic (comes on for no particular reason), however there are certain conditions and factors which have been linked to increased occurrence of frozen shoulder.

Such as:

  • Female population
  • Aged over 40
  • Diabetes
  • Underactive or overactive thyroid
  • Metabolic Syndrome
  • Post shoulder surgery or injury

What does a Frozen Shoulder feel like?

Madina’s Journey with a Frozen Shoulder and Steroid Injection Therapy

Madina Shares her Frozen Shoulder journey in this short film. She describes her pain and limitations to movement and how it is affecting her everyday life. We then follow her injection procedure called a “hydrodistension” and find out how she finds the procedure. If you think you might have a Frozen Shoulder, compare your symptoms with Madina and watch this video to see what the procedure involves.   


The shoulder is a ball and socket joint made up of the humerus (upper arm bone) and the scapular (shoulder blade). The socket on the scapula, know as the glenoid fossa, is not very big or deep which then requires additional support to prevent the shoulder becoming unstable. This anatomy however allows for a greater degree of motion that we utilise compared to other joints. To improve joint stability there is a thickening of the capsule that surrounds the joint which encapsulates the joint fluid. These thickenings are the ligaments of the shoulder joint. This is a also a group of 4 muscles that provide stability to keep ball in the socket known as the rotator cuff.

Shoulder anatomy

Frozen Shoulder Treatment

Although the majority of the time frozen shoulder will eventually resolve by itself, the current research found that effective treatments which shorten the duration of the symptoms have a significant impact on reducing long term problems.

Frozen shoulder Steroid injections in London

The latest evidence has found that the most effective treatment for frozen shoulder is the combination of physiotherapy and steroid injection (cortisone).

A recent systemic review and meta-analysis showed that a steroid injection into the shoulder joint was associated with increased short-term benefits compared with other non-operative treatments and the benefits may last as long as 6 months (Challoumas, et 2020).

The cortisone injection into the shoulder is used to reduce inflammation and pain, which is particularly beneficial in the early stages where pain is a greater issue than stiffness. This can also be performed as a “hydrodistension injection”- where the shoulder joint is also injected with a high volume of saline to stretch the tight joint capsule from the inside and allow movement. Having a course of intense physiotherapy shortly afterwards will then maximise recovery and improve the range of movement of the shoulder. Physiotherapy treatment will involve manual therapy including mobilisation of the joint and an independent exercise program to assist a speedy recovery.

What are the risk factors for developing a frozen shoulder?

  • It is more common in the female population
  • If you are aged over 40
  • If you have type 1 or 2 Diabetes
  • If you have an under or overactive thyroid
  • If you are recovering from shoulder surgery or had a recent injury to the shoulder

How do I know if I have a frozen shoulder?

  • If you have pain around the shoulder that is exacerbated by movement and especially overnight when sleeping
  • If you notice your shoulder flexibility is reducing eg you find it difficult to reach behind your lower back or above the head and you are struggling to dress
  • If you are not managing with over-the-counter painkillers and the pain is progressively worsening
  • If you have tried Physiotherapy or other management and the pain and stiffness is remaining


Do I need to have an injection for frozen shoulder?
No. An injection is optional and is designed to help relieve pain and promote range of motion in the shoulder. If pain is a feature of your frozen shoulder and you would like some relief, then you can consider having an injection to complement your recovery.
Will I only need 1 injection?
The majority of patients will only need 1 injection; however the nature of the condition can mean that a second injection may be required. This will depend on your response to the first injection and how much relief of symptoms you get. If you respond positively but it has not given you enough relief, then we may suggest a repeat injection.
Do you use anaesthetic during the injection?

Yes, we do inject local anaesthetic when we do the procedure. This will give you quick relief and make the procedure more tolerable. If you are allergic to local anaesthetic, it is important to discuss this with the treating clinician.

How long will the injection take to work?
Most people will get relief on the day due to the effect of the local anaesthetic. However, this will wear off after a few hours and it can take a few days and even up to 2 weeks for the steroid injection to reach its maximum potential. Most report symptomatic improvement within a few days which gradually improves up to the 2-week point.


Challoumas D, Biddle M, McLean M, Millar NL. Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(12):e2029581. doi:10.1001/jamanetworkopen.2020.29581

If you would like more information or would like to book an appointment, please contact us on 0207 636 5774 or email reception@oxfordcircusphysio.co.uk