Comparing Ultrasound-Guided Injection of Oxygen-Ozone vs. Corticosteroid vs. Prolotherapy in the Treatment of Shoulder Tendinopathy: A Prospective, Multicenter Randomized Clinical Trial
In brief
In 45 patients, steroids eased pain fastest, while other injections lasted longer
All three ultrasound-guided injections improved shoulder pain and function in this randomized trial of 45 patients. Steroid injections produced the least pain at 2 weeks, while prolotherapy had the lowest pain at 2 and 6 months; the authors also reported longer-lasting effects with prolotherapy and oxygen-ozone than with steroids. The small trial leaves their comparative benefit uncertain.
- Journal
- Pain research & management (Q1)
- Published
- 1 January 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Arash Babaei-Ghazani, Naseh Yousefi, Bijan Forogh, Lobaneh Janbazi, Tannaz Ahadi, Hosna Soleymanzadeh, et al.
- PMID
- 42808140
- DOI
- 10.1155/prm/1582085
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (paper of the day, 30 September 2026): Prospective multicenter RCT comparing complementary injections
Abstract
INTRODUCTION: Shoulder tendinopathy is the most common cause of shoulder pain and one of the most common musculoskeletal disorders, for which there is need for better treatment options with fewer complications. This study aimed to determine the effect of local injection of oxygen-ozone, corticosteroid, and prolotherapy under ultrasound guidance in the treatment of shoulder tendinopathy. METHODS: In this prospective, multicenter, randomized clinical trial, 45 patients with shoulder tendinopathy were selected by a sampling method and randomly assigned to three groups of 15 individuals each (local injection of oxygen-ozone, corticosteroid, and prolotherapy). Patients' symptoms were assessed using the Visual Analog Scale (VAS), Constant Score, Shoulder Pain and Disability Index (SPADI), range of motion, and ultrasound findings before treatment, 2 weeks, 2 months, and 6 months after intervention. RESULTS: VAS scores, SPADI, Constant Score, bursal thickness, and range of motion improved in all three groups following treatment. The lowest pain intensity based on the VAS scale at 2 weeks was observed in the corticosteroid group, while at 2 and 6 months, the lowest pain intensity was observed in the prolotherapy group. CONCLUSION: All three treatment options are effective for patients with shoulder tendinopathy. This study demonstrated that the effects of prolotherapy and oxygen-ozone injections last longer than those of corticosteroid injections. Corticosteroid injections are more effective for short-term pain relief. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT): IRCT20151017024572N17.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.