Reaching toward Effective Treatments for “Frozen Shoulder”

Talk to patients who’ve had one, and they’ll tell you it was no fun at all. Frozen shoulder, medically termed adhesive capsulitis, causes the shoulder joint to tighten up and become severely painful, making it difficult if not impossible to complete daily tasks.

Physical therapy treatments and in some cases injections into the shoulder joint help, but getting patients back to full function often takes weeks, even months. Doctors may recommend a more aggressive and immediate form of treatment that often provides prompt results. Manipulation under anesthesia, abbreviated MUA, is done by forcefully stretching the tight shoulder of a patient who’s asleep from anesthesia.

Which treatment for frozen shoulder works best? Or could the right combination of proven treatments work even better? Faster? To get to the bottom of these queries, researchers compared two ways of performing MUA for frozen shoulder. They tested whether MUA could be improved by first injecting a steroid medication into the shoulder joint.

Twenty-four patients underwent MUA and participated in the follow-up. Just over half had gotten the manipulation plus the steroid shot; the other group had the manipulation procedure without the shot.

Manipulation improved shoulder motion within one day in all but two patients. Four months later, all but three patients’ symptoms resolved. The profound improvements from the procedure led the authors to herald that “manipulation under anesthesia is a useful way to treat frozen shoulder.”

Interestingly, there were no major differences in results between those who’d gotten the shot and those who hadn’t. The shot simply didn’t add any measurable benefit. Thus, the authors recommend that these shots not be used in conjunction with the manipulation procedure.