PRP For Frozen Shoulder London
Frozen shoulder is painful, restricts movement severely and takes a long time to resolve on its own. The injection most people are offered is a corticosteroid, which works quickly. Recent trial evidence shows PRP performs comparably in the first month, then produces significantly better pain, function and range of movement at 3 and 6 months, with a more durable and safer profile. That trade-off is the whole decision.
Key points
A 2026 meta-analysis in Frontiers in Medicine pooled 13 randomised controlled trials covering 1,056 patients and found PRP gave significant advantages over corticosteroid in pain relief.
A separate 2026 meta-analysis found the two comparable up to 1 month, with PRP significantly better at 3 and 6 months, and improvement at 6 months highly likely to be clinically meaningful.
A 2024 systematic review of 14 randomised trials covering 1,024 patients concluded PRP was more durable and safer than corticosteroid, noting the recognised risk of osteonecrosis with steroids.
The evidence carries moderate to low certainty with high heterogeneity, so it should be read as favourable rather than settled, and we say so.
Shoulder locked up and not improving? Message a GMC-registered doctor on WhatsApp or email team@thewellnesslondon.com.
What frozen shoulder is
The condition
Frozen shoulder, also called adhesive capsulitis, is inflammation and then thickening and contracture of the capsule surrounding the shoulder joint. The capsule tightens, the joint loses room to move, and both pain and stiffness follow. It is most common in middle age, more frequent in women, and strongly associated with diabetes and thyroid disease.
The hallmark is loss of movement in all directions, including when someone else moves your arm for you. That distinguishes it from a rotator cuff problem, where the shoulder is usually painful to move yourself but can be moved passively.
The stages
It classically moves through three phases. A freezing phase of increasing pain lasting several months. A frozen phase where pain settles somewhat but stiffness dominates. A thawing phase where movement gradually returns. Left alone it often resolves, but the course commonly runs 1 to 3 years, and a proportion of people are left with lasting restriction. That timeline is why people seek treatment rather than waiting it out.
What the evidence shows
PRP against corticosteroid
The comparison that matters most, because corticosteroid is what you will usually be offered first.
A 2026 systematic review and meta-analysis published in Frontiers in Medicine pooled 13 randomised controlled trials covering 1,056 patients with adhesive capsulitis. Compared with corticosteroid, PRP showed significant advantages in pain relief.
A second 2026 meta-analysis found that both treatments produced comparable improvements in pain and function up to 1 month, with similarly low rates of mild complications, while PRP showed statistically significant improvements in pain, function and range of movement at 3 and 6 months. The authors judged the improvement at 6 months highly likely to be clinically significant.
A 2024 systematic review and meta-analysis of 14 randomised trials covering 1,024 patients concluded that PRP was more durable and safer than corticosteroid and other comparators, noting that corticosteroids carry a recognised risk of osteonecrosis while most PRP studies reported no adverse effects.
The honest caveats
The certainty of this evidence is moderate to low, with considerable heterogeneity between studies, different PRP preparations and varying risk of bias. Several of the authors say explicitly that the findings should be interpreted with caution.
So the fair summary is that the evidence favours PRP over steroid from around 3 months onward in frozen shoulder, that it appears at least as safe and probably safer, and that it is not proven to the standard of a settled question. We would rather you had that distinction than a confident claim.
Want to know where your shoulder sits? Ask our doctors on WhatsApp.
Choosing between the options
Corticosteroid
Works fastest and is the right choice when you need pain reduced now, particularly in the painful freezing phase where sleep is being destroyed. Its benefit tends to fade, repeated injections carry recognised risks including the osteonecrosis concern, and it does not change the capsule.
PRP
Slower to take effect, with the advantage appearing from around 3 months and holding at 6. Made from your own blood, so allergic reaction is very unlikely, and the safety signal across the trials is good. Suits someone who wants durable improvement rather than immediate relief, or who has already had steroid and found the benefit short-lived.
Physiotherapy
Not optional in either case. Movement work is the backbone of treatment for frozen shoulder, and an injection that reduces pain creates the window in which physiotherapy actually becomes possible. Injection without rehabilitation wastes the window.
Hydrodilatation and surgery
Hydrodilatation, which distends the capsule with fluid, and surgical release or manipulation under anaesthetic remain options in resistant cases. Where your shoulder has been frozen for a long time and is not moving despite proper treatment, that is the conversation to have, and we will say so.
Who does better
Better outcomes tend to follow when the diagnosis is confirmed rather than assumed, when the injection is image guided so it reaches the joint, when physiotherapy runs alongside from the start, and when diabetes or thyroid disease is identified and managed, since both are strongly associated and both affect the course.
Less well when the shoulder has been stiff for a very long time with severe established contracture, when there is an undiagnosed alternative cause such as a large rotator cuff tear or significant glenohumeral arthritis, and when injections are used as a substitute for movement work rather than an enabler of it.
Why image guidance matters here
The shoulder joint is not superficial, and a blind injection may not reach the capsule. Ultrasound guidance allows the needle and the target to be seen throughout, which both improves accuracy and confirms the injectate has gone where it was intended. It also allows the shoulder to be scanned so that a rotator cuff tear or calcific deposit is identified rather than missed.
What treatment costs in London
Image-guided joint PRP at specialist central London clinics commonly costs from around £780 to £900 or more per injection including assessment, and where a course is recommended a plan frequently exceeds £2,000. Outside central London the range is roughly £250 to £500, where injections are often performed without image guidance.
PRP is not routinely commissioned by the NHS for shoulder conditions and private insurance rarely covers it, so this is almost always self-pay. Corticosteroid injection and physiotherapy are both available on the NHS and are worth using.
Our care is doctor-led and priced below flagship central London rates, with your plan and the exact figure confirmed after your free suitability review rather than quoted before anyone has examined the shoulder.
Ask what your plan would cost. Message us on WhatsApp.
The suitability review
Every enquiry begins with a free doctor-led suitability review rather than a booking. A GMC-registered doctor takes your history, examines the shoulder including passive range of movement, scans it with ultrasound, checks for the associated conditions that change the picture, and gives one of two answers.
Approved for treatment, with the diagnosis, where the evidence sits for your stage, what to expect at 6 weeks, 3 months and 6 months, the physiotherapy that runs alongside and the cost before you commit.
Or not approved, in which case we explain what would serve you better. That may be a corticosteroid injection because you need relief now, physiotherapy you have not yet had properly, or a surgical opinion where the shoulder has been frozen a long time and is not responding.
We decline a meaningful share of shoulder enquiries, and referring someone onward is a routine outcome here rather than a failure.
Why people choose The London PRP Clinic by The Wellness
The London PRP Clinic by The Wellness is a doctor-led clinic treating from 10 Portman Square in Marylebone and the Light Centre in Belgravia. Every treatment is performed by GMC-registered doctors using image guidance, and no clinician treats a patient here until they have completed 100 supervised treatments.
We teach ultrasound-guided joint PRP to doctors through our Academy, and we are candid about evidence, including its limits. Across our work we report more than 187 five-star reviews.
Book your free suitability review. Message us on WhatsApp, email team@thewellnesslondon.com, or call +44 20 3951 3429.
Frequently asked questions about PRP for frozen shoulder
Does PRP work for frozen shoulder?
The evidence favours it. A 2026 meta-analysis of 13 randomised trials covering 1,056 patients found significant advantages over corticosteroid in pain relief, with benefit appearing from around 3 months. Certainty is moderate to low, so it is favourable rather than settled.
Is PRP better than a steroid injection for frozen shoulder?
They are comparable up to about 1 month, after which PRP performs significantly better at 3 and 6 months. Steroid works faster, which suits someone needing relief now.
How long does frozen shoulder last without treatment?
It often resolves eventually, but the course commonly runs 1 to 3 years and a proportion of people are left with lasting restriction, which is why most people seek treatment.
Do I still need physiotherapy?
Yes. Movement work is the backbone of treatment, and an injection creates the window in which physiotherapy becomes possible. Injection without rehabilitation wastes that window.
Does the injection need to be ultrasound guided?
The shoulder joint is not superficial, so guidance improves accuracy and confirms the injection reached the capsule. It also allows the shoulder to be scanned for other causes such as a cuff tear.
Is PRP for frozen shoulder available on the NHS?
Not routinely, and private insurance rarely covers it, so treatment is almost always self-pay. Corticosteroid injection and physiotherapy are available on the NHS.
This article is for information and does not replace personal medical advice. The evidence for PRP in adhesive capsulitis carries moderate to low certainty with high heterogeneity between studies, and PRP preparation is not standardised. All treatments at The London PRP Clinic by The Wellness are performed by GMC-registered doctors. Reviewed by Dr Shah, The London PRP Clinic by The Wellness. Last updated September 2026.
