Shoulder pain is one of the most common reasons patients walk through our doors at Aureum Physio. It limits sleep, daily function, and the ability to do the activities you love. Two of the most common treatments recommended in primary care are:

• Corticosteroid injections(to temporarily reduce inflammation and pain)
• Exercise-based physiotherapy(to restore strength, mobility, and long-term function)

But until recently, we had limited high-quality evidence comparing these options over a full year of recovery.

A 2025 randomized controlled trial, the SIX-Shoulder Study, followed 183 adults with shoulder pain for 12 months to determine which treatment provides better outcomes and

Study Comparison

Participants were randomly assigned to Corticosteroid Injection or Exercise Therapy (up to 12 physiotherapist-led, 30-minute strengthening and mobility sessions).  Both groups were monitored for pain, disability, quality of life, and healthcare usage.

Key Findings: Exercise Therapy Leads the Way

1. Exercise Therapy Provided Greater Long-Term Benefit

While injections can offer faster early pain relief, exercise therapy produced better long-term improvements in function and quality-adjusted life years (QALYs) over the full 12 months.

This supports what we see clinically at Aureum Physio: long-term recovery requires active treatment, not a short-term numbing effect.

2. Exercise Therapy Was More Cost-Effective Overall

Even though exercise therapy had higher upfront healthcare costs (more visits vs. 1–2 injections), it produced better long-term health value.  Exercise therapy had a 70% probability of being the more cost-effective option.

This means the improved outcomes justified the extra investment over the course of a year.

3. A Small Subgroup Drove Most Healthcare Costs

Interestingly, 16% of participants accounted for 74% of total costs, mostly due to lost work and decreased productivity.

This highlights how crucial early, targeted intervention is—injections may reduce symptoms, but do not meaningfully address dysfunction or prevent chronicity the way exercise-based rehabilitation does.

What This Means for You

If you’re dealing with shoulder pain, this study reinforces what the clinical evidence—and our own patient outcomes—continue to show:

Exercise-based physiotherapy should be the preferred first-line treatment.

Injections aren’t “bad” and may help reduce acute pain in some cases. However, injections do not:

• Restore joint mechanics
• Improve rotator cuff or scapular strength
• Normalize tendon loading
• Address movement patterns
• Reduce long-term recurrence risk

Exercise therapy does all of these.

At Aureum Physio, we integrate targeted loading strategies, mobility restoration, neuromuscular control, and personalized manual therapy to deliver a high-end, clinically grounded approach to shoulder rehabilitation.

The Bottom Line

For long-term recovery, improved function, and better value, exercise therapy outperforms corticosteroid injections over a 12-month period.
This aligns with what we see daily in the clinic: movement—not medication—is what creates lasting change.

If you’re experiencing shoulder pain, we can help you restore strength, mobility, and confidence—with a luxury wellness approach to evidence-based care.