Comprehensive Analysis of Frozen Shoulder Management

Abstract

Background: Frozen shoulder (FS) is a painful and debilitating condition characterized by progressive stiffness and restricted shoulder movement. It primarily affects middle-aged individuals, with a higher prevalence in women and those with metabolic disorders such as diabetes and hypertension. While FS is self-limiting, lasting 1–3 years, timely medical management with physiotherapy and interventions can accelerate recovery. This study evaluates the demographic profile, comorbidities, and treatment outcomes of FS patients managed at a pain clinic over four years.
Methods: This retrospective cross-sectional study included patients with frozen shoulder during the painful phase, treated at Nepal Pain Care and Research Center (Oct 2020–Oct 2024). Conservative treatment included analgesics (NASIDs and Paracetamol), Duloxetine, and physiotherapy. Non-responders underwent ultrasound-guided hydrodistension with 5% dextrose, lignocaine, methylprednisolone, and suprascapular block. Outcomes were assessed based on pain reduction, shoulder mobility, and daily function.
Results: All 112 patients with frozen shoulder were initially treated with conservative management. Out of these, 100 patients (89.3%) showed significant improvement. However, 12 patients (10.7%) did not respond well to conservative treatment and were therefore ultrasound-guided hydrodistension was done. Among them, 10 patients (83.3%) experienced noticeable improvement, while 2 patients (16.7%) reported reduced pain but no improvement in their range of motion.
Conclusions: Conservative treatments proved effective in most cases (89.3%), while ultrasound-guided hydrodistension was beneficial for resistant cases (83.3%).
Keywords: Frozen shoulder; physiotherapy; hydrodistension.