Frozen shoulder: Current concept of management

Abstract

BACKGROUND: Frozen shoulder is a musculoskeletal disorder resulting from chronic inflammation of the capsule subsynovial layer and characterized with capsular thickening, progressive fibrosis, and contracture of the glenohumeral joint capsule. This condition is a relatively common condition that mimics other condition and its management requires deliberate consideration of patient’s condition. REVIEW ARTICLE: This article reviews and summarize latest findings of frozen shoulder. The diagnosis of frozen shoulder is described from the patient history, physical examination in look, feel, and move sequence to the supporting examinations. The current evidence of managements of frozen shoulder is described, from the nonoperative to the surgical approach. CONCLUSION: Most of frozen shoulder cases resolve spontaneously thus conservative treatment should be the first choice of frozen shoulder. However, for cases that failed with conservative treatment and had a debilitating effect to patient’s daily life or cases with history of surgery, operative treatment should be considered. Operative treatment is aimed to release the capsule either by manipulation under anesthesia, by arthroscopy, or by open surgery. Physical rehabilitation following every procedure is mandatory and key to maintain range of motion years following the surgery.