From the Research
Treatment options for frozen shoulder should prioritize a combination of pain management, physical therapy, and potentially more invasive interventions, with a focus on improving quality of life and reducing morbidity and mortality. The most recent and highest quality study, 1, published in 2023, suggests that diagnosis is clinical, based on global motion restriction and pain, and that physical therapy, nonsteroidal anti-inflammatories, and injection therapies are standard treatments. Key treatment considerations include:
- Pain control with NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) to manage symptoms
- Corticosteroid injections into the glenohumeral joint, typically using 40mg of methylprednisolone or equivalent, for temporary relief during the painful freezing phase
- Physical therapy, including gentle stretching exercises focusing on external rotation, internal rotation, and forward elevation, performed 2-3 times daily for 10-15 minutes each session
- Heat application before exercises and ice afterward to enhance comfort
- Consideration of more aggressive interventions, such as hydrodilatation, manipulation under anesthesia, or arthroscopic capsular release, for persistent cases It is essential to note that recovery typically takes 12-18 months regardless of treatment, but appropriate interventions can reduce pain and improve function during this period, as highlighted in 2 and 3. Additionally, the condition results from thickening and contraction of the joint capsule with subsequent formation of adhesions, which explains why stretching and maintaining range of motion are fundamental to treatment success, as discussed in 4 and 5. Overall, a comprehensive treatment approach, prioritizing pain management, physical therapy, and potentially more invasive interventions, can help improve outcomes for patients with frozen shoulder, as supported by the latest evidence from 1.