Physical therapy for frozen shoulder

Abstract

Frozen shoulder, or adhesive capsulitis is usually described as inflammation and fibrosis of the glenohumeral joint capsule and coracohumeral ligament. It is a very common condition with the prevalence of 2 - 5% in the general population, and 10 - 20% of the diabetic population, mostly between ages 40 - 65 years old; and as females are more affected than males. It has a gradually spontaneous onset of pain and progresses to loss of active and passive glenohumeral joint motions which further lead to limit the shoulder function.                        A classification of frozen shoulder is divided into 2 types: primary and secondary types. The primary type arises spontaneously without an obvious preceding event but the secondary type is associated with intrinsic, extrinsic and systemic factors. The risk factors are trauma, surgery, diabetes, thyroid, cardiac, Parkinson’s
diseases, and stroke.

The diagnosis of frozen shoulder is based on a past history and physical examination without formal criteria. There are a number of treatments for frozen shoulder including resting, analgesic and NSAIDs, corticosteroid injections, physical therapy, manipulation under anesthesia and arthroscopic capsular releasing.

Physical therapy and home exercise programs are importantly considered as conservative treatment of frozen shoulder for relieving pain, preventing joint stiffness, increasing range of motion, restoring muscular strength and gaining function of shoulder.