Evaluation of conservative treatment of frozen shoulder: A clinical study

Author(s): Dr. Naresh Mitna, Dr. Smit Jakheria, Dr. Vivek Dubey, Dr. Abhishek Lahiri and Dr. Vishvajeet Singh

Abstract: The frozen shoulder (adhesive capsulitis) is a clinical syndrome complicated by a surfeit of synonyms. The true mechanism has been the grist of innumerable scholarly effort. Strangely the diagnosis is not difficult although the precise cause may be elusive. The present study was conducted upon 100 patients. The inclusion criteria was to consider patients with gradual onset with classical phasic character of the disease, pain in the shoulder joint, limitation of movements which may only be slight in the beginning and objective signs of diffuse tenderness, muscle spasm or wasting of muscles. Once the diagnosis was established, the patients were divided in to three groups which were then managed accordingly with only physiotherapy, steroid and local anaesthesia injection with physiotherapy and manipulation under anaesthesia with local steroid injection. The observations were based on a twelve week follow up study of these cases. Most of the patients were in their sixth decade of life. The mean age of the patients were 50.96 years. In our study, 58% were females whereas 42% were males. 50% of the patients had involvement of right shoulder and in the remaining 50% left shoulder was involved. Only one patient had involvement of both the shoulder joint. In our series, most of the patients came to seek medical advice after some interval from the onset. The majority of them reported between 2-4 months since the onset of symptoms, average duration being 4.3 months. There was appreciable wasting of deltoid and supraspinatus in 57 cases and muscle spasm was there in 43 cases. All the patient had pain at limits of motion. The combined results at the end of 12 weeks follow-up were; out of 100 patients and 101 shoulders (one case bilateral involvement) treated, 44 graded as excellent, 39 as good, 14 as fair and remaining four as poor. The authors believe that the patients with frozen shoulder should be diagnosed promptly and regular follow up is needed for better evaluation of their response to treatment.

DOI: https://doi.org/10.22271/ortho.2019.v5.i4h.1716