Conservative Treatment for Frozen Shoulder Is Effective Regardless of the Severity of Symptoms

Abstract

Purpose: To analyze the recovery duration of pain and functional activity after conservative treatment, including oral medication, injections, and rehabilitation, for frozen shoulder among patients based on the severity of their symptoms.

Methods: The study involved patients with new reports of shoulder night pain considered more severe than daytime pain and limited range of motion between January 2021 and December 2021 at the Tokyo Sports and Orthopaedic Clinic. Patients with recent shoulder treatment, a history of shoulder injury, rotator cuff tears, arthritic changes, or shoulder trauma were excluded. After dividing patients into 3 groups by severity of stiffness (group 1, severe; group 2, moderate; and group 3, mild), we recorded retrospective data on range of motion and details of conservative treatment, such as oral medication, injection frequency, and physical therapy, each time the patient visited.

Results: The study included 113 shoulders from 106 patients (39 men and 67 women), with a mean age of 54 years (range, 43-75 years). For night pain treatment, median recovery time was 1, 1, and 0.5 months for groups 1, 2, and 3, respectively, with no significant difference. Group 1 used oral medication and injections significantly more than groups 2 and 3 (P < .004). No significant differences were found in the number of rehabilitation sessions among the 3 groups, which had averages of 17.5, 12, and 16 sessions in groups 1, 2, and 3, respectively. Median recovery times for range of motion were 10, 9, and 12 months in groups 1, 2, and 3, with no significant differences. Similar results were observed for oral medication duration, injection frequency, and rehabilitation sessions. Group 1 had median durations of 1 month for oral medication, 3 injections, and 17.5 rehabilitation sessions; group 2 had durations of 1 month, 2 injections, and 12 sessions; group 3 had durations of 1, 1.5, and 16 months for oral medication, injections, and rehabilitation sessions, respectively.

Conclusions: Conservative treatment is effective for the treatment of frozen shoulder. In this study, it improved night pain within a month and enhanced range of motion significantly within a year.

Level of evidence: Level III, retrospective cohort study.