The effectiveness of interventions in the management of patients with primary frozen shoulder

Abstract

There are many types of treatment used to manage the frozen shoulder, but there is no consensus on how best to manage patients with this painful and debilitating condition. We conducted a review of the evidence of the effectiveness of interventions used to manage primary frozen shoulder using the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Physiotherapy Evidence Database, MEDLINE and EMBASE without language or date restrictions up to April 2009. Two authors independently applied selection criteria and assessed the quality of systematic reviews using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Data were synthesised narratively, with emphasis placed on assessing the quality of evidence. In total, 758 titles and abstracts were identified and screened, which resulted in the inclusion of 11 systematic reviews. Although these met most of the AMSTAR quality criteria, there was insufficient evidence to draw firm conclusions about the effectiveness of treatments commonly used to manage a frozen shoulder. This was mostly due to poor methodological quality and small sample size in primary studies included in the reviews. We found no reviews evaluating surgical interventions. More rigorous randomised trials are needed to evaluate the treatments used for frozen shoulder.

Clinical Findings of Arthroscopic Release in Treatment of Primary Frozen Shoulder

“…These results are similar to those obtained in studies conducted by other researchers. In a study conducted by Waszczykoski et al on 30 patients suffering from frozen shoulder, after a 2-year follow-up, it was seen that arthroscopic release improved significantly shoulder range of motion and function in primary and secondary frozen shoulders (14)(15)(16)(17). Our study obtained similar results.…”

“…In Ozbaydar et al study on 16 patients with frozen shoulder who had arthroscopic selective capsular release, it was seen that patients not responding to conservative treatment were treated effectively by this method (5). In Rookmomeea et al study, after review of different methods of frozen shoulder treatment in various articles, no definitive and effective method was recognized (17). In another study by Musil et al on 27 patients with frozen shoulder, they found that arthroscopic release is the preferred treatment in patients who do not respond to conservative treatment.…”

Frozen shoulder

“…The need for standardisation in diagnosis has recently been emphasised and a system of terminology and classification based on consensus would be advantageous. 1 In this review, we use the term frozen shoulder, as it is the most commonly used and avoids the ambiguities associated with terms that attempt to describe the underlying pathology.…”

“…A multidisciplinary approach is preferable, and most patients can be managed non-operatively in a primary care setting with the expectation of a good outcome. There are many alternative forms of treatment for this condition, but evidence of their efficacy is not well-established from clinical trials, 1 and it is unclear if several interventions used in combination are better.…”

Comparison of Oral Glucocorticoid and Only Analgesics in the Treatment of Idiopathic Frozen Shoulder

“…Treatment methods include oral analgesics, oral glucocorticoids, intraarticular glucocorticoids, physiotherapy, manipulation and arthroscopic release [3][4][5][6] . These modalities can be used separately or in combinations but effectiveness of each of this method is different in various clinical trials 7 . Oral glucocorticoids and home exercise program is very effective in first stage of frozen shoulder 8 but many studies have mentioned physiotherapy alone with analgesics as good tool to relive pain and gain long term range of motion.…”