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Should I get a steroid injection for my frozen shoulder? The doctor thinks this will help me sleep but says it doesn't give long-lasting benefit. The shoulder's been bugging me for months now and I'm exhausted but I've heard steroid shots are bad for you. What do you think?

Adhesive capsulitis, sometimes called a "frozen shoulder" is a problem that comes on gradually causing pain, loss of shoulder motion, and decreased function. It disrupts the person's life during the "frozen" stage. And then the problem goes away as mysteriously as it came on. These three stages (freezing, frozen, and thawing) can last anywhere from months to years. In the end, most people come out okay without any major long-lasting effects. But, in the meantime, the painful symptoms, difficulty sleeping at night, and loss of shoulder function during the day can be very disabling. The patient's quality of life suffers. What can be done to help the you during these three stages? There are four main treatment methods: 1) antiinflammatory medications, 2) physical therapy, 3) steroid injections, and 4) surgical manipulation. As you have found out, the injection (a combination of a powerful antiinflammatory and numbing agent) gives immediate but often temporary relief from the pain. This allows you to roll onto that side at night or sleep uninterrupted for more than a few hours. It also makes it possible to move more freely and that's an important part of the recovery process. As the saying goes, "motion is lotion." Studies show that combining a steroid injection with physical therapy can give you the best results. Although it's true that any form of treatment (including doing nothing) yields the same final outcomes, it can be months and even years before the shoulder problem is resolved. The injection and rehab can get you through the difficult, painful stages and may even speed up the healing process. One steroid injection isn't likely to cause any significant problems. Patients are warned against repeated injections because the medication can weaken the soft tissue fibers. That effect can put you at risk for injury. The natural history of adhesive capsulitis is eventual resolution of the problem. A steroid injection can provide comfort and function through the early stages.

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