How to treat frozen shoulder

Abstract

Introduction: This article summarizes version 1.0 of the Norwegian clinical guideline for the physiotherapy treatment of frozen shoulder. The guideline was developed using the method described at the Helsebiblioteket.no. This guideline aims to provide advice and recommendations for the treatment of patients with frozen shoulder. Main part: Frozen shoulder is a condition of unknown cause where the shoulder becomes painful and stiff. The joint capsule thickens and tightens. Both active and passive shoulder motion become restricted. The course of the disease can be divided into two phases: the painful phase and the stiffness phase. The treatment of frozen shoulder should include education about the condition, its course, patient self-management and treatment options. Activity modification might be necessary. Anti-inflammatory drugs such as paracetamol and/or non-steroidal anti-inflammatory drugs (NSAIDs) can be used if required. Injection of corticosteroids can be considered for patients with severe pain. Exercises for mobility, muscular control, strength and endurance might be used in both phases of the disease. Exercises and stretching that provoke more pain are not recommended. Conclusion: Treatment of frozen shoulder should include patient education, analgesic treatment if required, and exercises that do not increase pain.

Keywords

• frozen shoulder
• physiotherapy
• guideline