# Comparison of the efficacy of platelet-rich plasma versus corticosteroid in the treatment of adhesive capsulitis: a systematic review and meta-analysis based on randomized controlled trials

## TL;DR

A meta-analysis comparing platelet-rich plasma and corticosteroid injections for shoulder pain found PRP more effective in long-term pain relief and mobility improvement.

## Contribution

This study provides a systematic review and meta-analysis comparing PRP and corticosteroid efficacy for adhesive capsulitis.

## Key findings

- PRP showed better pain relief and mobility at 6 months compared to corticosteroids.
- No significant differences were found in short-term (1-3 months) outcomes between the two treatments.
- PRP demonstrated significant improvements in abduction, external rotation, and internal rotation at 6 months.

## Abstract

Adhesive capsulitis (AC) often impairs patients’ quality of life due to shoulder pain and restricted joint mobility. Intra-articular shoulder injection is a profound conservative treatment modality. Existing randomized controlled trials (RCTs) have reported conflicting results regarding the efficacy of platelet-rich plasma (PRP) versus corticosteroid (CS) injections. Therefore, a meta-analysis of the relevant RCTs is warranted.

A systematic search was conducted across four databases (PubMed, Embase, the Cochrane Library, and Web of Science) for articles published from their inception to September 15, 2025. RCTs comparing the efficacy of PRP versus CS injections for the treatment of AC were included. The primary outcomes were the Visual Analog Scale (VAS) score and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Secondary outcomes included range of motion (ROM): abduction, flexion, external rotation, and internal rotation.

This meta-analysis included a total of 13 studies involving 1,056 patients with AC. Among them, 531 patients were allocated to the PRP group and 525 to the CS group. No statistically significant differences were observed between the two groups in the VAS and DASH scores at 1 month, VAS score at 3 months, or flexion ROM. However, compared with the CS group, the PRP group demonstrated significantly superior outcomes in the VAS score at 6 months, DASH scores at 3 and 6 months, as well as in abduction, external rotation, and internal rotation. Specifically, significant differences were observed in: the 6-month VAS score (MD: –1.84, 95% CI: −2.57 to −1.10, p < 0.00001), the 3-month DASH score (MD: –5.88, 95% CI: −9.72 to −2.03, p = 0.003), the 6-month DASH score (MD: –14.42, 95% CI: −16.35 to −12.49, p < 0.00001), abduction (MD: 11.90, 95% CI: 2.23 to 21.57, p = 0.02), external rotation (MD: 8.39, 95% CI: 1.39 to 15.40, p = 0.02), and internal rotation (MD: 10.04, 95% CI: 8.80 to 11.29, p < 0.00001).

Compared with CS, PRP for AC demonstrated significant advantages in pain relief, functional improvement, and range of motion recovery at the 6-month follow-up. However, the two treatments showed comparable efficacy in terms of pain relief at the 1- to 3-month follow-ups and functional improvement at the 1-month follow-up.

https://www.crd.york.ac.uk/PROSPERO/, CRD420251156731.