The Open Orthopaedics Journal


ISSN: 1874-3250 ― Volume 11, 2017

Adhesive Capsulitis of the Shoulder. Is there Consensus Regarding the Treatment? A Comprehensive Review



Dimitrios Georgiannos1, George Markopoulos1, Eirini Devetzi2, Ilias Bisbinas1, *
1 Orthopaedics and Trauma Surgery 424 Military General Hospital, Thessaloniki, Greece
2 Rheumatology 424 Military General Hospital, Thessaloniki, Greece

Abstract

Background:

Adhesive capsulitis of the shoulder (ACS) is a common self-limiting condition characterized by disabling pain and restricted movements. Its pathophysiology is poorly understood, clinically it is characterized by stages of pain and stiffness, and finally often patients never recover fully. However, there is no consensus about available methods of treatment for ACS. The aims of this paper are to discuss and develop issues regarding approaches to management in ACS in the stages of it.

Methods:

A review of the literature was performed and guidelines for the treatment of that clinical entity for doctors and health care professionals are provided.

Results:

Anti-inflammatory medications, steroid and/or hyaluronate injections and physiotherapy is the mainstay of conservative management either alone in the first stages or in combination with other treatment modalities in the later stages. Next line of treatment, involving minor to moderate intervention, includes suprascapular nerve block, distension arthrography and manipulation under anaesthesia. In order to avoid complications of “blind intervention”, arthroscopic capsular release is gradually more commonly applied, and in recalcitrant severe cases open release is a useful option.

Conclusion:

Various modalities of conservative management and gradually more surgical release are applied. However, often clinicians choose on personal experience and training rather than on published evidence.

Keywords: Adhesive capsulitis, Shoulder, Treatment.


Article Information


Identifiers and Pagination:

Year: 2017
Volume: 11
Issue: Suppl-1, M2
First Page: 65
Last Page: 76
Publisher Id: TOORTHJ-11-65
DOI: 10.2174/1874325001711010065

Article History:

Received Date: 03/01/2016
Revision Received Date: 14/04/2016
Acceptance Date: 20/04/2016
Electronic publication date: 28/02/2017
Collection year: 2017

© 2017 Georgiannos et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Orthopaedics and Trauma Surgery, 424 Military General Hospital, Thessaloniki, Greece; Tel: 0030 2310 381000; ext 2610; E-mail: ibisbinas@hotmail.com




INTRODUCTION

Adhesive capsulitis of the shoulder (ACS) is a common disease characterized by disabling pain and restricted movements. Neviaser in 1945 suggested that the term “adhesive capsulitis” better described the pathology- adhesions between the axillary fold and the humeral neck and the “misnomer frozen shoulder should be deleted from the medical literature” [1Neviaser J. Adhesive capsulitis of the shoulder. A study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg Am 1945; 27: 211-22.]. The term “Frozen Shoulder” (FS) is coined to Codman in 1934 [2Codman EA. The shoulder. Boston: Thomas Todd 1934.], although it was Duplay in 1896 who described a clinical condition with the same characteristics and named it as “periarthrite scapulohumerale” [3Duplay S. Periarthritis of the glenohumeral joint in the shoulder. Rev Pract D Trav de Med 1896; 53: 226.]. The condition has also been termed “frozen shoulder syndrome” [4Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 1969; 119: 1-59.
[http://dx.doi.org/10.3109/ort.1969.40.suppl-119.01] [PMID: 4952729]
], and “contracture of shoulder” [5Bunker T. Time for a new name for frozen shoulder-contracture of the shoulder. Shoulder Elbow 2009; 1: 4-9.
[http://dx.doi.org/10.1111/j.1758-5740.2009.00007.x]
]. The multiple terms used to describe the disease shows poor understanding of the pathology and etiology [6Neviaser RJ, Neviaser TJ. The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res 1987; (223): 59-64.
[PMID: 3652593]
]. Bunker proposed an interim term “HGAC” the acronym for “humeroglenoid acromioclavicular” syndrome, which is quite confusing for patients and doctors [7Bunker TD. Time for a new name for frozen shoulder. Br Med J (Clin Res Ed) 1985; 290(6477): 1233-4.
[http://dx.doi.org/10.1136/bmj.290.6477.1233] [PMID: 3921169]
]. The American Shoulder and Elbow Society (ASES) resulted in a consensus definition of ACS as follows: “a condition characterized by functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are essentially unremarkable” [8Zuckerman J, Rokito S. Definition and classification of frozen shoulder: a consensus approach. J Shoulder Elbow Surg 2011; 83: 322-35.
[http://dx.doi.org/10.1016/j.jse.2010.07.008] [PMID: 21051244]
].

EPIDEMIOLOGY - AETIOLOGY - PATHOPHYSIOLOGY

ACS occurs in 2-5% of the general population and up to 20% in diabetic patients [8Zuckerman J, Rokito S. Definition and classification of frozen shoulder: a consensus approach. J Shoulder Elbow Surg 2011; 83: 322-35.
[http://dx.doi.org/10.1016/j.jse.2010.07.008] [PMID: 21051244]
]. It occurs more commonly in women between 40 and 60 years and in a quarter of the patients the disease is bilateral [8Zuckerman J, Rokito S. Definition and classification of frozen shoulder: a consensus approach. J Shoulder Elbow Surg 2011; 83: 322-35.
[http://dx.doi.org/10.1016/j.jse.2010.07.008] [PMID: 21051244]
]. ACS has been classified as primary -idiopathic- and secondary - intrinsic, extrinsic and systemic due to predisposing factors [9Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 1995; 77(5): 677-83.
[PMID: 7559688]
, 10Huang YP, Fann CY, Chiu YH, et al. Association of diabetes mellitus with the risk of developing adhesive capsulitis of the shoulder: a longitudinal population-based followup study. Arthritis Care Res (Hoboken) 2013; 65(7): 1197-202.
[http://dx.doi.org/10.1002/acr.21938] [PMID: 23281342]
]. The most frequent predisposing factor leading to ACS is diabetes mellitus with its incidence been in diabetes patients between 10-36% [11Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005; 331(7530): 1453-6.
[http://dx.doi.org/10.1136/bmj.331.7530.1453] [PMID: 16356983]
]. Further, associations include cardiac disease, pulmonary disease, Parkinson's disease and stroke, hyperthyroidism, hypothyroidism, scleroedema, Dupuytren’s disease or previous non-shoulder surgery including cardiac surgery, thoracic, neck surgery or neurosurgery or shoulder trauma as rotator cuff injury [11Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005; 331(7530): 1453-6.
[http://dx.doi.org/10.1136/bmj.331.7530.1453] [PMID: 16356983]
].

The pathophysiology of ACS is not clear. It starts without a specific precipitating event, as an inflammatory reaction in the shoulder capsule. The presence of cytokines is evidence of a possible autoimmune process, which however has not established relations or aetiology [12Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther 2010; 5(4): 266-73.
[PMID: 21655385]
]. After active fibroblastic proliferation in the shoulder capsule, fibroblasts start transforming to myofibroblasts causing inflammatory contracture, capsular hyperplasia and fibrosis reducing the capsular volume and restricting the glenohumeral movements [13Uppal HS, Evans JP, Smith C. Frozen shoulder: A systematic review of therapeutic options. World J Orthop 2015; 6(2): 263-8.
[http://dx.doi.org/10.5312/wjo.v6.i2.263] [PMID: 25793166]
].

Pain and decreased range of motion (ROM) are the principle symptoms all the way through the course of adhesive capsulitis. The symptoms can persist for 12-24 months. Interestingly, 10% of patients never recover full ROM. However, this loss of motion is seldom functionally limiting [12Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther 2010; 5(4): 266-73.
[PMID: 21655385]
].

STAGES AND DIAGNOSTIC CRITERIA

It is commonly believed that ACS is an idiopathic, self-limiting syndrome divided into four consecutive stages lasting approximately 24 months in total [6Neviaser RJ, Neviaser TJ. The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res 1987; (223): 59-64.
[PMID: 3652593]
]; 1. Painful stage: characterized by gradual onset of symptoms which persist for less than 3 months and consist of mild to severe pain, mild limitation of range ROM, and inability lying on the affected shoulder. 2. Freezing stage: symptoms continue for 3-9 months, characterized by severe nocturnal pain and significant loss of both active and passive ROM. 3. Frozen stage: symptoms persist for 9-14 months and characterized by shoulder stiffness and pain at the end of motion or at night. 4. Thawing stage: occurs between 15-24 months and characterized by minimal pain and a gradual improvement of ROM due to capsular remodeling.

The formal diagnostic criteria include: 1.painful and stiff shoulder for at least 4 weeks; 2. severe shoulder pain that interferes with activities of daily living or work; 3. night pain; 4. painful restriction of both passive and active shoulder range of motion (elevation <100°, external rotation >50% restriction); and 5.normal radiological appearance [14Brue S, Valentin A, Forssblad M, Werner S, Mikkelsen C, Cerulli G. Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc 2007; 15(8): 1048-54.
[http://dx.doi.org/10.1007/s00167-007-0291-2] [PMID: 17333122]
]. Aim of this article is to review the current literature on treatment of this painful, disabling and often debilitating condition.

TREATMENT

Some authors believe that pain relief is the main objective of all treatments for ACS [15Noël E, Thomas T, Schaeverbeke T, Thomas P, Bonjean M, Revel M. Frozen shoulder. Joint Bone Spine 2000; 67(5): 393-400.
[PMID: 11143905]
]. However, considering the functional disability and its impact on the patients, this objective should be refined to early pain relief and functional restoration [16Dodenhoff RM, Levy O, Wilson A, Copeland SA. Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity. J Shoulder Elbow Surg 2000; 9(1): 23-6.
[http://dx.doi.org/10.1016/S1058-2746(00)90005-3] [PMID: 10717858]
]. Choice of treatment approach depends upon the patient’s functional status at the time of presentation. Generally speaking a trial of conservative care is warranted for 6 months provided the clinician closely monitors progress. If progress stalls or the condition worsens, an alternate approach to treatment should be considered [17Neviaser TJ. Adhesive capsulitis. Orthop Clin North Am 1987; 18(3): 439-43.
[PMID: 3441364]
].

Conservative Treatment

Oral Medication

Non steroidal anti-inflammatory drugs (NSAIDs) have been widely used for the treatment of ACS, especially at the painful first phase of disease. According to the literature, some studies- even with questionable clinical evidence- showed significant improvement of pain in patients treated with NSAIDs compared with placebo [18van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol 1995; 48(5): 691-704.
[http://dx.doi.org/10.1016/0895-4356(94)00170-U] [PMID: 7730924]
]. Others support the use of NSAIDs at the earlier inflammatory stages of the ACS claiming that they may provide short-term pain relief [19Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011; 20(3): 502-14.
[http://dx.doi.org/10.1016/j.jse.2010.08.023] [PMID: 21167743]
, 20Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med 2010; 38(11): 2346-56.
[http://dx.doi.org/10.1177/0363546509348048] [PMID: 20110457]
].

Oral corticosteroids can also be used and have been shown to improve pain, especially night pain [18van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol 1995; 48(5): 691-704.
[http://dx.doi.org/10.1016/0895-4356(94)00170-U] [PMID: 7730924]
], and ROM in the short term [21Binder A, Hazleman BL, Parr G, Roberts S. A controlled study of oral prednisolone in frozen shoulder. Br J Rheumatol 1986; 25(3): 288-92.
[http://dx.doi.org/10.1093/rheumatology/25.3.288] [PMID: 3730737]
-25Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; 1(1): CD007005.
[PMID: 18254123]
]. Buchbinder et al. [24Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(11): 1460-9.
[http://dx.doi.org/10.1136/ard.2003.018218] [PMID: 15479896]
] in a randomized controlled trial (RCT) concluded that oral steroids provide significant short term benefits in pain relief, ROM and function. A recent systematic review [25Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; 1(1): CD007005.
[PMID: 18254123]
] concluded similar results, with “silver” level evidence that oral steroids provide significant short-term improvement but the effect may not be maintained beyond six weeks. Minimal adverse effects were reported with the use of steroids.

Intra-Articular Injection

Intra-articular corticosteroid injections are used commonly to manage ACS for many years, quelling the inflammation process and reducing the patient’s symptoms [26Favejee MM, Huisstede BM, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventionssystematic review. Br J Sports Med 2011; 45(1): 49-56.
[http://dx.doi.org/10.1136/bjsm.2010.071431] [PMID: 20647296]
]. The number of injections as well as the injection techniques used varies. The dose of steroid used ranges from 20 to 60 mg Triamcinolon [27Tveita EK, Tariq R, Sesseng S, Juel NG, Bautz-Holter E. Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord 2008; 9: 53.
[http://dx.doi.org/10.1186/1471-2474-9-53] [PMID: 18423042]
, 28Griesser MJ, Harris JD, Campbell JE, Jones GL. Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. J Bone Joint Surg Am 2011; 93(18): 1727-33.
[http://dx.doi.org/10.2106/JBJS.J.01275] [PMID: 21938377]
]. Often corticosteroid injections are performed as a mixture with a local anesthetic. The improvement of ROM is attributed to the effect of the local anaesthetic medication that reduces the pain and the muscle spasm [29Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am 2006; 37(4): 531-9.
[http://dx.doi.org/10.1016/j.ocl.2006.09.009] [PMID: 17141009]
]. The effect has been described to last up to 6 weeks, and the injections are more effective when synovitis is present during the early stage of ACS [30Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract 2007; 57(541): 662-7.
[PMID: 17688763]
, 31Lorbach O, Anagnostakos K, Scherf C, Seil R, Kohn D, Pape D. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg 2010; 19(2): 172-9.
[http://dx.doi.org/10.1016/j.jse.2009.06.013] [PMID: 19800262]
]. The injection can be targeted into the glenohumeral or subacromial space without significant differences as about its effectiveness [32Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP. Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg 2011; 20(7): 1034-40.
[http://dx.doi.org/10.1016/j.jse.2011.04.029] [PMID: 21816628]
]. Multiple studies have shown that the use of ultrasound or fluoroscopy to guide injections improves the accuracy of these injections compared with a blind technique [33Lee HJ, Lim KB, Kim DY, Lee KT. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Arch Phys Med Rehabil 2009; 90(12): 1997-2002.
[http://dx.doi.org/10.1016/j.apmr.2009.07.025] [PMID: 19969160]
-36Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. Arthroscopy 2002; 18(8): 887-91.
[http://dx.doi.org/10.1053/jars.2002.35263] [PMID: 12368787]
]. Juel et al. [37Juel NG, Oland G, Kvalheim S, Løve T, Ekeberg OM. Adhesive capsulitis: one sonographic-guided injection of 20 mg triamcinolon into the rotator interval. Rheumatol Int 2013; 33(6): 1547-53.
[http://dx.doi.org/10.1007/s00296-012-2503-4] [PMID: 23263492]
] has recently described a new injection technique with an ultrasound-guided injection of 20 mg triamcinolon into the rotator interval with significant effects on ROM after 12 weeks. Steroid injections were compared with placebo, supervised physiotherapy and intra-articular sodium hyaluronate injection in three high quality RCTs [38Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 2006; 26(6): 536-40.
[http://dx.doi.org/10.1007/s00296-005-0022-2] [PMID: 16091920]
-40Ryans I, Montgomery A, Galway R, Kernohan WG, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford) 2005; 44(4): 529-35.
[http://dx.doi.org/10.1093/rheumatology/keh535] [PMID: 15657070]
].

Sodium hyaluronate injection into the shoulder joint is a relatively new intervention for the management of adhesive capsulitis. Hyaluronate is a major component of connective tissue and has metabolic effects on articular cartilage, synovial tissue and synovial fluid [41Iwata H. Pharmacologic and clinical aspects of intraarticular injection of hyaluronate. Clin Orthop Relat Res 1993; 199(289): 285-91.
[PMID: 8472428]
]. Hyaluronic acid injections have been shown to be beneficial for persistent shoulder pain especially when the main reason is osteoarthritis of the glenohumeral joint [42Moskowitz RW, Blaine TA. An overview of treatment options for persistent shoulder pain. Am J Orthop 2005; 34(12)(Suppl.): 10-5.
[PMID: 16450691]
, 43Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg Am 2008; 90(5): 970-9.
[http://dx.doi.org/10.2106/JBJS.F.01116] [PMID: 18451387]
]. Harris et al. in a review article showed that hyaluronate injection into the glenohumeral joint is a safe and effective procedure improving pain and ROM at short-term follow up in patients with ACS [44Harris JD, Griesser MJ, Copelan A, Jones GL. Treatment of adhesive capsulitis with intra-articular hyaluronate: A systematic review. Int J Shoulder Surg 2011; 5(2): 31-7.
[http://dx.doi.org/10.4103/0973-6042.83194] [PMID: 21897581]
]. However, Callis et al. in a comparative study demonstrated that hyaluronic acid intra-articular injections were not as effective as the intra-articular corticosteroid injections or physiotherapy for the treatment of ACS [38Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 2006; 26(6): 536-40.
[http://dx.doi.org/10.1007/s00296-005-0022-2] [PMID: 16091920]
]. Finally, Lin-Fen Hsieh et al. in a RCT showed that the addition of hyaluronic acid injections to conventional physiotherapy did not produce a significant added benefit for the treatment of patients with ACS and may increase unnecessary medical expenditures [45Hsieh LF, Hsu WC, Lin YJ, Chang HL, Chen CC, Huang V. Addition of intra-articular hyaluronate injection to physical therapy program produces no extra benefits in patients with adhesive capsulitis of the shoulder: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93(6): 957-64.
[http://dx.doi.org/10.1016/j.apmr.2012.01.021] [PMID: 22502793]
].

Physiotherapy

Physiotherapy is considered an important factor of maintaining movement by preventing capsular contraction and regaining ROM once symptoms allow and it is widely accepted that it should be used in the conservative management of ACS [46Wilson J, Russell S, Walton M. The management of frozen shoulder. Curr Phys Med Rehabil Rep 2015; 3: 181-7.
[http://dx.doi.org/10.1007/s40141-015-0090-5]
, 47DOrsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a review. Muscles Ligaments Tendons J 2012; 2(2): 70-8.
[PMID: 23738277]
]. A variety of interventions were used, which included among others heat or ice applications, active and passive ROM exercises, mobilization techniques, stretching, patient’s education and supervised home exercises, laser therapy, transcutaneous electrical nerve stimulation and proprioceptive neuromuscular fascilitation techniques (PNF) [48Vermeulen HM, Rozing PM, Obermann WR, le Cessie S, Vliet Vlieland TP. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther 2006; 86(3): 355-68.
[PMID: 16506872]
]. The use of ultrasound, massage, iontophoresis and photophoresis has been discouraged by some authors and they seemed to be of no benefit for the treatment of ACS, reducing the likelihood of a favorable outcome [49Jewell DV, Riddle DL, Thacker LR. Interventions associated with an increased or decreased likelihood of pain reduction and improved function in patients with adhesive capsulitis: a retrospective cohort study. Phys Ther 2009; 89(5): 419-29.
[http://dx.doi.org/10.2522/ptj.20080250] [PMID: 19270045]
].

Joint mobilization techniques such as traction and glide were used to stretch the adhered capsule and improve the physiologic accessory movements [50Paul A, Rajkumar JS, Peter S, Lambert L. Effectiveness of sustained stretching of the inferior capsule in the management of a frozen shoulder. Clin Orthop Relat Res 2014; 472(7): 2262-8.
[http://dx.doi.org/10.1007/s11999-014-3581-2] [PMID: 24664198]
]. Traction involved distraction of one articular surface perpendicular to the other and gliding involved translational movement of one articular surface parallel to the other. Johnson et al., in a study comparing anterior versus posterior glide mobilization, concluded that posterior joint mobilization was more effective than anterior for improving external rotation after three therapeutic sessions [51Johnson AJ, Godges JJ, Zimmerman GJ, Ounanian LL. The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis. J Orthop Sports Phys Ther 2007; 37(3): 88-99.
[http://dx.doi.org/10.2519/jospt.2007.2307] [PMID: 17416123]
]. The intensity of stretching has to match with the patient’s patience and the tissue’s ability to cope with physical stress [52Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther 2013; 43(5): A1-A31.
[http://dx.doi.org/10.2519/jospt.2013.0302] [PMID: 23636125]
].

Diercks et al. in an RCT of 77 patients showed that intensive physical rehabilitation can be counter-productive comparing one group performing passive stretching and mobilization beyond pain limits (intensive physiotherapy group) with a second group performing active and actively assisted exercises within pain limits (supervised neglect group). At two years only 63% of the first group and 89% of the second group had good shoulder function [53Diercks RL, Stevens M. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg 2004; 13(5): 499-502.
[http://dx.doi.org/10.1016/j.jse.2004.03.002] [PMID: 15383804]
]. However, Vermeulen et al. in a RCT concluded that high grade mobilization techniques are more effective than low grade ones in the management of ACS of the shoulder despite of patients were improved significantly with both treatment strategies [48Vermeulen HM, Rozing PM, Obermann WR, le Cessie S, Vliet Vlieland TP. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther 2006; 86(3): 355-68.
[PMID: 16506872]
]. Another recent study by Russel et al. showed that anxiety and depression appear to be an important part of ACS symptoms and physiotherapy interventions in a group exercise class provided superior outcomes in relieving signs and symptoms because they particularly addressed this aspect of the condition [54Russell S, Jariwala A, Conlon R, Selfe J, Richards J, Walton M. A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. J Shoulder Elbow Surg 2014; 23(4): 500-7.
[http://dx.doi.org/10.1016/j.jse.2013.12.026] [PMID: 24630545]
]. Finally, when selecting a physical treatment method for ACS it is important to consider the patient’s symptoms, stage of condition and recognition of different patterns of motion loss [55Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol 2014; 33(5): 593-600.
[http://dx.doi.org/10.1007/s10067-013-2464-3] [PMID: 24374758]
]. It is also important to educate the patient explaining the pathology and self-limiting character of the condition, acknowledging that full ROM might never be restored [52Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther 2013; 43(5): A1-A31.
[http://dx.doi.org/10.2519/jospt.2013.0302] [PMID: 23636125]
].

Suprascapular Nerve Block

Suprascapular nerve block (SNB), first described in 1941, aims to block the nerves to the glenohumeral joint as they branch from the suprascapular nerve near the scapular notch [56Wertheim HM, Rovenstime FA. Suprascapular nerve block. Anesthesiology 1941; 2: 541-5.
[http://dx.doi.org/10.1097/00000542-194109000-00006]
]. The block could be repeated twice weekly for a total of 2-4 treatments [57Wassef MR. Suprascapular nerve block. A new approach for the management of frozen shoulder. Anaesthesia 1992; 47(2): 120-4.
[http://dx.doi.org/10.1111/j.1365-2044.1992.tb02007.x] [PMID: 1539779]
]. Jones et al. compared the therapeutic effects of SNB to intra-articular corticosteroid injection, and found that the technique was safe, effective and has several benefits over intra-articular injection [58Jones DS, Chattopadhyay C. Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial. Br J Gen Pract 1999; 49(438): 39-41.
[PMID: 10622015]
]. A RCT conducted by Dahan et al. compared three SNB with bupivacaine at weekly interval with placebo. SNB offered significant pain relief but no improvement with regard to ROM [59Dahan TH, Fortin L, Pelletier M, Petit M, Vadeboncoeur R, Suissa S. Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol 2000; 27(6): 1464-9.
[PMID: 10852272]
]. Ultrasound-guided placement of a perineural catheter to provide continuous SNB has also been proposed in a case report [60Børglum J, Bartholdy A, Hautopp H, Krogsgaard MR, Jensen K. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review. Acta Anaesthesiol Scand 2011; 55(2): 242-7.
[http://dx.doi.org/10.1111/j.1399-6576.2010.02370.x] [PMID: 21226866]
].

Distension Arthrography

Distension arthrography is a procedure where an injection of a saline solution and/or steroids or air into the shoulder joint breaks up the adhesions that might limiting the movements of the glenohumeral joint and causing pain and disability. Arthrographic distension of the shoulder capsule leading to capsular rupture was first described by Anderson and Lundberg [61Andren L, Lundberg BJ. Treatment of rigid shoulders by joint distension during arthrography. Acta Orthop Scand 1965; 36: 45-53.
[http://dx.doi.org/10.3109/17453676508989370] [PMID: 14308098]
]. Distension could be done with a mixture of long acting anaesthetics, steroids, saline or air. Because of the inherent compressibility of air, distension of a contracted capsule is more difficult than if saline is used [62Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1): 25-35.
[PMID: 17987207]
]. Dependent upon the contracted state of the joint capsule, distension usually occurred when between 10ml and 55ml of normal saline had been injected. Rupture usually occurred through the subscapularis bursa and occasionally down the biceps sheath [62Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1): 25-35.
[PMID: 17987207]
]. Corbeil et al. contacted a double-blind prospective trial comparing intra-articular steroid injection vs arthrographic distension and found no significant difference between the two groups [63Corbeil V, Dussault RG, Leduc BE, Fleury J. Adhesive capsulitis of the shoulder: a comparative study of arthrography with intra-articular corticotherapy and with or without capsular distension. Can Assoc Radiol J 1992; 43(2): 127-30.
[PMID: 1562888]
]. Jacob et al. compared three interventions in a RCT. Shoulder distension with air, intra-articular steroid injection and distension with air and steroids. They concluded that intra-articular steroid injection and distension plus steroids to be superior to distension alone, but there was no significant difference between steroid injection with or without [64Jacobs LG, Barton MA, Wallace WA, Ferrousis J, Dunn NA, Bossingham DH. Intra-articular distension and steroids in the management of capsulitis of the shoulder. BMJ 1991; 302(6791): 1498-501.
[http://dx.doi.org/10.1136/bmj.302.6791.1498] [PMID: 1855018]
]. Buchbinder et al. compared arthrographic distension with steroid and saline versus placebo. There was significant improvement of ROM, pain and disability in the distension group compared to placebo group [24Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(11): 1460-9.
[http://dx.doi.org/10.1136/ard.2003.018218] [PMID: 15479896]
]. A RCT conducted by Gam et al. showed significant improvement in ROM and lower need for analgesics in the arthrographic group, but no difference in pain or function compared with the steroid injection group [65Gam AN, Schydlowsky P, Rossel I, Remvig L, Jensen EM. Treatment of frozen shoulder with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. Scand J Rheumatol 1998; 27(6): 425-30.
[http://dx.doi.org/10.1080/030097498442244] [PMID: 9855212]
]. Hsu and Chan reported a prospective study comparing MUA and physiotherapy with arthroscopic distension and physiotherapy, and with physiotherapy alone. They reported no significant difference between the first two groups regarding pain, ROM and function [66Hsu SY, Chan KM. Arthroscopic distension in the management of frozen shoulder. Int Orthop 1991; 15(2): 79-83.
[http://dx.doi.org/10.1007/BF00179702] [PMID: 1917198]
]. Other studies although non RCTs, but with long follow-up (up to 28 months) concluded that arthrographic distension is a safe and effective treatment of frozen shoulder that gives long-term improvement [62Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1): 25-35.
[PMID: 17987207]
, 67Clement RG, Ray AG, Davidson C, Robinson CM, Perks FJ. Frozen shoulder : long-term outcome following arthrographic distension. Acta Orthop Belg 2013; 79(4): 368-74.
[PMID: 24205764]
, 68Watson L, Bialocerkowski A, Dalziel R, Balster S, Burke F, Finch C. Hydrodilatation (distension arthrography): a long-term clinical outcome series. Br J Sports Med 2007; 41(3): 167-73.
[http://dx.doi.org/10.1136/bjsm.2006.028431] [PMID: 17178772]
]. Park et al. in a RCT, compared ultrasound guided capsular distension with hyaluronic acid with steroid injection alone [69Park KD, Nam HS, Lee JK, Kim YJ, Park Y. Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil 2013; 94(2): 264-70.
[http://dx.doi.org/10.1016/j.apmr.2012.10.002] [PMID: 23063625]
]. They concluded that capsular distension with hyaluronic acid was as effective as the steroid injection alone regarding the pain relief and function but more effective regarding the passive external rotation movements [69Park KD, Nam HS, Lee JK, Kim YJ, Park Y. Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil 2013; 94(2): 264-70.
[http://dx.doi.org/10.1016/j.apmr.2012.10.002] [PMID: 23063625]
].

Manipulation Under Anaesthesia (MUA)

MUA can be considered after 6 months of refractory pain and stiffness in patients with ACS [19Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011; 20(3): 502-14.
[http://dx.doi.org/10.1016/j.jse.2010.08.023] [PMID: 21167743]
, 70Grant JA, Schroeder N, Miller BS, Carpenter JE. Comparison of manipulation and arthroscopic capsular release for adhesive capsulitis: a systematic review. J Shoulder Elbow Surg 2013; 22(8): 1135-45.
[http://dx.doi.org/10.1016/j.jse.2013.01.010] [PMID: 23510748]
]. It consists of a controlled, forced restoration of shoulder movements. Elevation and abduction releases the inferior capsule due to rupture of the capsule from the humeral neck. Forced external rotation tears the coracohumeral ligament allowing for improvement of rotational movements [46Wilson J, Russell S, Walton M. The management of frozen shoulder. Curr Phys Med Rehabil Rep 2015; 3: 181-7.
[http://dx.doi.org/10.1007/s40141-015-0090-5]
]. Dodenhoff et al. concluded that MUA is a safe procedure that provides early improvement of the shoulder function [16Dodenhoff RM, Levy O, Wilson A, Copeland SA. Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity. J Shoulder Elbow Surg 2000; 9(1): 23-6.
[http://dx.doi.org/10.1016/S1058-2746(00)90005-3] [PMID: 10717858]
]. Farrell et al. reported excellent results in 70% of patients treated with MUA at 15 years follow-up [71Farrell CM, Sperling JW, Cofield RH. Manipulation for frozen shoulder: long-term results. J Shoulder Elbow Surg 2005; 14(5): 480-4.
[http://dx.doi.org/10.1016/j.jse.2005.02.012] [PMID: 16194738]
]. Wang et al. concluded that MUA accelerates ACS recovery and improves shoulder function and symptoms within a short period of time. They were also reported neither recurrence of symptoms in 8 year follow-up nor residual complications [72Wang JP, Huang TF, Ma HL, Hung SC, Chen TH, Liu CL. Manipulation under anaesthesia for frozen shoulder in patients with and without non-insulin dependent diabetes mellitus. Int Orthop 2010; 34(8): 1227-32.
[http://dx.doi.org/10.1007/s00264-010-0968-x] [PMID: 20157810]
]. Jacobs et al. conducted a RCT comparing MUA versus intra-articular steroids and concluded that there is no difference regarding the speed of reduction in pain or improvement in function [73Jacobs LG, Smith MG, Khan SA, Smith K, Joshi M. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg 2009; 18(3): 348-53.
[http://dx.doi.org/10.1016/j.jse.2009.02.002] [PMID: 19393928]
]. Kivimaki et al. reported no differences at 3, 6 and 12 months between MUA and exercises compared with physiotherapy exercises alone in an RCT [74Kivimäki J, Pohjolainen T, Malmivaara A, et al. Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: a randomized, controlled trial with 125 patients. J Shoulder Elbow Surg 2007; 16(6): 722-6.
[http://dx.doi.org/10.1016/j.jse.2007.02.125] [PMID: 17931902]
]. DeCarli et al. showed that patients undergoing a MUA with an arthroscopic capsular release had better outcomes at 6 weeks but no difference at 12 weeks compared with patients undergoing intra-articular corticosteroid injection [75De Carli A, Vadalà A, Perugia D, et al. Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections? Int Orthop 2012; 36(1): 101-6.
[http://dx.doi.org/10.1007/s00264-011-1330-7] [PMID: 21833684]
]. Reichmister andFriedman reported that 97% of patients treated with MUA had significant improvement of pain and ROM, however 8% required a second MUA [76Reichmister JP, Friedman SL. Long-term functional results after manipulation of the frozen shoulder. Md Med J 1999; 48(1): 7-11.
[PMID: 10048277]
].

Surgical Treatment

Arthroscopic Release

The effectiveness of arthroscopy in treatment of ACS has been confirmed by several studies [77Harryman DT II, Matsen FA III, Sidles JA. Arthroscopic management of refractory shoulder stiffness. Arthroscopy 1997; 13(2): 133-47.
[http://dx.doi.org/10.1016/S0749-8063(97)90146-8] [PMID: 9127069]
-80Walther M, Blanke F, Von Wehren L, Majewski M. Frozen shouldercomparison of different surgical treatment options. Acta Orthop Belg 2014; 80(2): 172-7.
[PMID: 25090788]
]. Ogilvie-Harris et al. first described the arthroscopic anterior capsulotomy for the treatment of ACS. They suggested that the inferior capsular release should be avoided in order to prevent injury to the axillary nerve [81Ogilvie-Harris DJ, Wiley AM. Arthroscopic surgery of the shoulder. A general appraisal. J Bone Joint Surg Br 1986; 68(2): 201-7.
[PMID: 3958003]
]. Le Lievre et al. [82Le Lievre HM, Murrell GA. Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 2012; 94(13): 1208-16.
[http://dx.doi.org/10.2106/JBJS.J.00952] [PMID: 22760389]
] showed that patients underwent arthroscopic capsular release maintained the initial good results regarding pain, function and ROM for over 7 years [82Le Lievre HM, Murrell GA. Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 2012; 94(13): 1208-16.
[http://dx.doi.org/10.2106/JBJS.J.00952] [PMID: 22760389]
]. Interestingly, improvement of internal rotation might be very poor. Several authors performed a posterior release to increase the range of internal rotation however this has shown to make no difference [83Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009; 25(1): 19-23.
[http://dx.doi.org/10.1016/j.arthro.2008.08.006] [PMID: 19111214]
]. There is no consensus regarding the extent of capsular release and which structures should be involved in release. Many authors release only the rotator cuff interval and the contracted coracohumeral ligament claiming excellent results [84Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. J Shoulder Elbow Surg 2004; 13(2): 180-5.
[http://dx.doi.org/10.1016/j.jse.2003.12.004] [PMID: 14997096]
-86Baums MH, Spahn G, Nozaki M, Steckel H, Schultz W, Klinger HM. Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis. Knee Surg Sports Traumatol Arthrosc 2007; 15(5): 638-44.
[http://dx.doi.org/10.1007/s00167-006-0203-x] [PMID: 17031613]
] while some others suggest that releasing the superior edge of subscapularis is essential t restore the external rotation [87Liem D, Meier F, Thorwesten L, Marquardt B, Steinbeck J, Poetzl W. The influence of arthroscopic subscapularis tendon and capsule release on internal rotation strength in treatment of frozen shoulder. Am J Sports Med 2008; 36(5): 921-6.
[http://dx.doi.org/10.1177/0363546507313090] [PMID: 18272795]
-89Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
]. A posterior capsular release might improve a severely restricted internal rotation [13Uppal HS, Evans JP, Smith C. Frozen shoulder: A systematic review of therapeutic options. World J Orthop 2015; 6(2): 263-8.
[http://dx.doi.org/10.5312/wjo.v6.i2.263] [PMID: 25793166]
, 83Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009; 25(1): 19-23.
[http://dx.doi.org/10.1016/j.arthro.2008.08.006] [PMID: 19111214]
]. A ‘360° capsulectomy’ has been recently utilized by several surgeons although this technique associated with higher risk of axillary nerve injury [19Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011; 20(3): 502-14.
[http://dx.doi.org/10.1016/j.jse.2010.08.023] [PMID: 21167743]
, 89Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
-91Lafosse L, Boyle S, Kordasiewicz B, Aranberri-Gutiérrez M, Fritsch B, Meller R. Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy 2012; 28(7): 916-23.
[http://dx.doi.org/10.1016/j.arthro.2011.12.014] [PMID: 22421567]
]. Chen et al. reported poor functional outcomes at 3 months after capsulotomy without inferior release [92Chen J, Chen S, Li Y, Hua Y, Li H. Is the extended release of the inferior glenohumeral ligament necessary for frozen shoulder? Arthroscopy 2010; 26(4): 529-35.
[http://dx.doi.org/10.1016/j.arthro.2010.02.020] [PMID: 20362834]
]. Ogilvie-Harris et al. compared arthroscopic release with MUA. They concluded that arthroscopic release is the treatment of choice for resistant ACS ensuring more substantial and rapid ROM and pain improvement controlled with lower risk of complications [93Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M. The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res 1995; (319): 238-48.
[PMID: 7554636]
].

Open Release

With the development of arthroscopic techniques, open release is nowadays rarely performed and is mentioned only for historical purposes. There are several studies in the literature suggesting that open release could be used for recalcitrant cases of ACS and good results with complete pain relief and full ROM restoration are reported [94Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 1989; 71(10): 1511-5.
[http://dx.doi.org/10.2106/00004623-198971100-00009] [PMID: 2592391]
, 95Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 2001; 10(4): 353-7.
[http://dx.doi.org/10.1067/mse.2001.115986] [PMID: 11517365]
].

DISCUSSION

The level of evidence of studies regarding the various treatments for ACS is generally low especially with regard to surgical treatments. RCTs are difficult to perform because of the difficulties regarding the clinical diagnosis as well as the various stages of ACS in the recruited patients. Therefore, most of the studies are mainly case series or retrospective comparative studies [19Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011; 20(3): 502-14.
[http://dx.doi.org/10.1016/j.jse.2010.08.023] [PMID: 21167743]
].

Despite the widespread use of NSAIDs, there is no evidence in the literature to support their effectiveness for the treatment of ACS [18van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol 1995; 48(5): 691-704.
[http://dx.doi.org/10.1016/0895-4356(94)00170-U] [PMID: 7730924]
-20Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med 2010; 38(11): 2346-56.
[http://dx.doi.org/10.1177/0363546509348048] [PMID: 20110457]
]. Oral steroids appear to provide significant short-term improvement but their effect may not be maintained beyond six weeks. Furthermore the use of oral steroids for a long period involves long-term systematic side effects [24Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(11): 1460-9.
[http://dx.doi.org/10.1136/ard.2003.018218] [PMID: 15479896]
, 25Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; 1(1): CD007005.
[PMID: 18254123]
].

Although, many studies showed significant early benefit of intra-articular injections on pain and shoulder ROM, no differences were found after three months between various treatments. They may be more efficacious in the early inflammatory stage without substantial capsular contracture however this finding has yet to be proven with higher level studies [27Tveita EK, Tariq R, Sesseng S, Juel NG, Bautz-Holter E. Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord 2008; 9: 53.
[http://dx.doi.org/10.1186/1471-2474-9-53] [PMID: 18423042]
, 28Griesser MJ, Harris JD, Campbell JE, Jones GL. Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. J Bone Joint Surg Am 2011; 93(18): 1727-33.
[http://dx.doi.org/10.2106/JBJS.J.01275] [PMID: 21938377]
]. The combination of steroid injection with physiotherapy appeared more effective than physiotherapy or steroid injections alone in the recovery of range of motion [47DOrsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a review. Muscles Ligaments Tendons J 2012; 2(2): 70-8.
[PMID: 23738277]
].

Physiotherapy and exercises are often used to prevent capsular contracture and improve shoulder ROM. Home exercise program with gentle stretching seemed to provide better results than more intensive physiotherapy regimes although there is no sufficient evidence about the most effective physiotherapy [96Buchbinder R, Youd JM, Green S, et al. Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: a randomized trial. Arthritis Rheum 2007; 57(6): 1027-37.
[http://dx.doi.org/10.1002/art.22892] [PMID: 17665470]
, 97Maund E, Craig D, Suekarran S, et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess 2012; 16(11): 1-264.
[http://dx.doi.org/10.3310/hta16110] [PMID: 22405512]
]. Regarding the physical therapy, there is good evidence that the laser therapy and the deep heating especially is very effective if applied additionally to mobilization techniques or exercise programs [98Wong PL, Tan HC. A review on frozen shoulder. Singapore Med J 2010; 51(9): 694-7.
[PMID: 20938608]
].

Suprascapular nerve block is proved a safe, simple, highly successful and reproducible alternate for the treatment of ACS in the primary care [58Jones DS, Chattopadhyay C. Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial. Br J Gen Pract 1999; 49(438): 39-41.
[PMID: 10622015]
, 99Karataş GK, Meray J. Suprascapular nerve block for pain relief in adhesive capsulitis: comparison of 2 different techniques. Arch Phys Med Rehabil 2002; 83(5): 593-7.
[http://dx.doi.org/10.1053/apmr.2002.32472] [PMID: 11994796]
]. It could be used alone or in combination with steroids for additional pain control. Blockage of the suprascapular nerve, which contains a substantial proportion of sympathetic fibers supplying the shoulder joint, cause significant pain relief [57Wassef MR. Suprascapular nerve block. A new approach for the management of frozen shoulder. Anaesthesia 1992; 47(2): 120-4.
[http://dx.doi.org/10.1111/j.1365-2044.1992.tb02007.x] [PMID: 1539779]
].

Capsular distension of shoulder joint has been recommended for patients with ACS resistant to conservative treatment [24Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(11): 1460-9.
[http://dx.doi.org/10.1136/ard.2003.018218] [PMID: 15479896]
, 62Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1): 25-35.
[PMID: 17987207]
, 67Clement RG, Ray AG, Davidson C, Robinson CM, Perks FJ. Frozen shoulder : long-term outcome following arthrographic distension. Acta Orthop Belg 2013; 79(4): 368-74.
[PMID: 24205764]
]. There is only “silver” level evidence that arthrographic distension with saline and steroid provides short-term benefits in pain, ROM and function in ACS and that no conclusions from the existing RCT’s can be made on the long-term outcome [25Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; 1(1): CD007005.
[PMID: 18254123]
].

There is no consensus about the safety of MUA. Several iatrogenic complications, such as haemarthrosis, glenohumeral ligament rupture, glenoid labral detachment, SLAP lesions, rotator cuff tendon tears, and humeral fractures have been reported [100Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. J Shoulder Elbow Surg 2005; 14(1): 16-21.
[http://dx.doi.org/10.1016/j.jse.2004.04.004] [PMID: 15723009]
]. The use of injections is recommended rather than MUA and physiotherapy as a first-line treatment for patients in the freezing phase of ACS [73Jacobs LG, Smith MG, Khan SA, Smith K, Joshi M. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg 2009; 18(3): 348-53.
[http://dx.doi.org/10.1016/j.jse.2009.02.002] [PMID: 19393928]
].

Arthroscopic capsular release has been favored over MUA as it allows a complete release of the contracted capsule, reduces the chance of fracture and provides immediate improvement [82Le Lievre HM, Murrell GA. Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 2012; 94(13): 1208-16.
[http://dx.doi.org/10.2106/JBJS.J.00952] [PMID: 22760389]
]. However, there is still controversy regarding the optimum way of release. The primary source of pathology in ACS is the rotator interval [9Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 1995; 77(5): 677-83.
[PMID: 7559688]
]. Therefore, it is the release of that area in conjunction with the inferior capsule that provides the greatest improvement in ROM [83Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009; 25(1): 19-23.
[http://dx.doi.org/10.1016/j.arthro.2008.08.006] [PMID: 19111214]
, 65Gam AN, Schydlowsky P, Rossel I, Remvig L, Jensen EM. Treatment of frozen shoulder with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. Scand J Rheumatol 1998; 27(6): 425-30.
[http://dx.doi.org/10.1080/030097498442244] [PMID: 9855212]
]. In contrast, several authors have recently utilized the ‘360° total capsular release’ [89Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
-91Lafosse L, Boyle S, Kordasiewicz B, Aranberri-Gutiérrez M, Fritsch B, Meller R. Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy 2012; 28(7): 916-23.
[http://dx.doi.org/10.1016/j.arthro.2011.12.014] [PMID: 22421567]
]. The major advantage of arthroscopic capsular release compared to open one, is that the physical therapy and exercise can be initiated immediately after surgery [89Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
]. It is also valuable in patients with osteoporosis that are difficult and dangerous to perform MUA. Other benefits of the arthroscopic capsular release include the ability to allow release of the rotator interval, the anterior and posterior capsule, and the inferior pouch; debridement of the subscapularis tendon; denervation of the glenohumeral joint capsule; removal of synovial tissue [89Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
].

Open release is considered the last chance for the most recalcitrant cases after failure of the arthroscopic release and MUA as associated with several complications such as prolonged recovery, stiffness, postoperative pain that can delay early mobilization [47DOrsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a review. Muscles Ligaments Tendons J 2012; 2(2): 70-8.
[PMID: 23738277]
, 94Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 1989; 71(10): 1511-5.
[http://dx.doi.org/10.2106/00004623-198971100-00009] [PMID: 2592391]
, 95Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 2001; 10(4): 353-7.
[http://dx.doi.org/10.1067/mse.2001.115986] [PMID: 11517365]
].

Obviously, there is insufficient evidence to draw solid conclusions about which treatment is the most effective [101Rookmoneea M, Dennis L, Brealey S, et al. The effectiveness of interventions in the management of patients with primary frozen shoulder. J Bone Joint Surg Br 2010; 92(9): 1267-72.
[http://dx.doi.org/10.1302/0301-620X.92B9.24282] [PMID: 20798446]
]. In the absence of clear direction from the literature a realistic approach to patient management needs to be planned. A survey study [102Dennis L, Brealey S, Rangan A, et al. Managing idiopathic frozen shoulder: a survey of health professionals' current practice and research priorities. Shoulder Elbow 2010; 2: 294-300.
[http://dx.doi.org/10.1111/j.1758-5740.2010.00073.x]
] among healthcare professionals (orthopaedic surgeons, general practitioners, physiotherapists) stated that most professionals recommended non-operative treatment in the painful phase including oral analgesia and physiotherapy. 18% of the professionals recommended injections in the first instance, 3% recommended arthroscopic release and 1.4% advocated capsular distension. Another survey study among shoulder orthopaedic surgeons enquiring on surgeons’ treatment preference revealed that the management of ACS varies both with regard to non-surgical and surgical options. Most of them based their choice of treatment on personal experience and training rather than on published studies [103Kwaees TA, Charalambous CP. Surgical and non-surgical treatment of frozen shoulder. Survey on surgeons treatment preferences. Muscles Ligaments Tendons J 2015; 4(4): 420-4.
[PMID: 25767778]
].

Table 1
Goals and treatment modalities which are suggested-applied for ACS treatment in each phase.


The treatment of ACS should be based on the stage of the disease and on patient characteristics. A treatment algorithm is proposed in Table 1. Well educated patients and reassurance regarding the disease increases compliance and improves the treatment outcome. However, it is important to emphasize that the full ROM may never recover. In the painful phase, the goal of treatment is to reduce pain and to preserve shoulder mobility and function. Oral NSAIDs and/or intra-articular steroid injections or intra-articular hyaluronate injections indicated for the first 4 weeks. Additionally, stretching and exercise program within the pain threshold could be used for better results. In the freezing phase, the goal of treatment is to prevent stiffness and reduce the formation of intra-articular adhesions. Physiotherapy plays the most important role of treatment in the freezing phase. The exercise program includes passive mobilization, active exercises, daily home exercises and internal-external stretching exercises with the use of pulleys. The duration and intensity of program should be based on the pain threshold. Intra-articular corticosteroids are generally used to improve the synovitis, thus reducing the natural history of disease. Capsular distension is a treatment option, very favorite among the shoulder surgeons in this phase. In the frozen phase, the goal of treatment is to improve the marked loss of ROM of the shoulder. Capsular distension, MUA, and arthroscopic release could be used alone or in combination to restore a proper dynamic shoulder joint. Physiotherapy is used to maintain the achievements of the invasive technique used. The control of pain with NSAIDs or injections is important to increase the intensity, duration and frequency of exercises. The addition of deep heating to stretching exercises and mobilization can produce a greater improvement in ROM through the relaxation of the surrounding musculature. In the thawing phase, the goal of treatment is the restoration of the normal function of the shoulder. Arthroscopic release is widely used. Open release could be used for very stiff shoulders. Additionally, stretching and proprioceptive exercises are prescribed in order to correct the compensatory movements and restore a well-built dynamic shoulder joint.

CONCLUSION

Adhesive capsulitis of the shoulder is a disabling disease often with up to 24 months recovery. Although, many treatment modalities have been reported for the management of the ACS, there is still no consensus in the literature regarding which therapeutic option is superior, mostly because of a lack of high-level evidence. Given that ACS is a self-limiting condition, conservative management is the first choice in the first stage of the disease. Physiotherapy and active and passive exercises, combined with oral medication and/or intra-articular corticosteroid injections, are considered most important in the conservative treatment of ACS. After failure of conservative treatment invasive options can be considered. It seems that distension arthrography combined with gentle MUA is being increasingly used as a first line of invasive treatment and is being considered more and more by clinicians before arthroscopic capsular release. High quality RCTs with long follow-up should be designed to compare different treatment options and to formulate precise guidelines about the treatment of ACS.

LIST OF ABBREVIATIONS

ACS  = Adhesive capsulitis of the shoulder
ASES  = American shoulder and elbow society
FS  = Frozen shoulder
HGAC syndrome  = Humeroglenoid acromioclavicular” syndrome
MUA  = Manipulation under anaesthesia
NSAIDs  = Non-steroidal anti-inflammatory drugs
PNF  = Proprioceptive neuromuscular fascilitation techniques
RCT  = Randomized controlled trial
ROM  = Range of motion
SNB  = Suprascapular nerve block

CONFLICT OF INTEREST

The authors confirm that this article content has no conflict of interest.

ACKNOWLEDGEMENTS

The authors thank Medical student Miss Vasiliki Bisbinas for providing precious help with the literature search and the English language refinement during the writing of this paper.

REFERENCES

[1] Neviaser J. Adhesive capsulitis of the shoulder. A study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg Am 1945; 27: 211-22.
[2] Codman EA. The shoulder. Boston: Thomas Todd 1934.
[3] Duplay S. Periarthritis of the glenohumeral joint in the shoulder. Rev Pract D Trav de Med 1896; 53: 226.
[4] Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 1969; 119: 1-59.
[http://dx.doi.org/10.3109/ort.1969.40.suppl-119.01] [PMID: 4952729]
[5] Bunker T. Time for a new name for frozen shoulder-contracture of the shoulder. Shoulder Elbow 2009; 1: 4-9.
[http://dx.doi.org/10.1111/j.1758-5740.2009.00007.x]
[6] Neviaser RJ, Neviaser TJ. The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res 1987; (223): 59-64.
[PMID: 3652593]
[7] Bunker TD. Time for a new name for frozen shoulder. Br Med J (Clin Res Ed) 1985; 290(6477): 1233-4.
[http://dx.doi.org/10.1136/bmj.290.6477.1233] [PMID: 3921169]
[8] Zuckerman J, Rokito S. Definition and classification of frozen shoulder: a consensus approach. J Shoulder Elbow Surg 2011; 83: 322-35.
[http://dx.doi.org/10.1016/j.jse.2010.07.008] [PMID: 21051244]
[9] Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 1995; 77(5): 677-83.
[PMID: 7559688]
[10] Huang YP, Fann CY, Chiu YH, et al. Association of diabetes mellitus with the risk of developing adhesive capsulitis of the shoulder: a longitudinal population-based followup study. Arthritis Care Res (Hoboken) 2013; 65(7): 1197-202.
[http://dx.doi.org/10.1002/acr.21938] [PMID: 23281342]
[11] Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005; 331(7530): 1453-6.
[http://dx.doi.org/10.1136/bmj.331.7530.1453] [PMID: 16356983]
[12] Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther 2010; 5(4): 266-73.
[PMID: 21655385]
[13] Uppal HS, Evans JP, Smith C. Frozen shoulder: A systematic review of therapeutic options. World J Orthop 2015; 6(2): 263-8.
[http://dx.doi.org/10.5312/wjo.v6.i2.263] [PMID: 25793166]
[14] Brue S, Valentin A, Forssblad M, Werner S, Mikkelsen C, Cerulli G. Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc 2007; 15(8): 1048-54.
[http://dx.doi.org/10.1007/s00167-007-0291-2] [PMID: 17333122]
[15] Noël E, Thomas T, Schaeverbeke T, Thomas P, Bonjean M, Revel M. Frozen shoulder. Joint Bone Spine 2000; 67(5): 393-400.
[PMID: 11143905]
[16] Dodenhoff RM, Levy O, Wilson A, Copeland SA. Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity. J Shoulder Elbow Surg 2000; 9(1): 23-6.
[http://dx.doi.org/10.1016/S1058-2746(00)90005-3] [PMID: 10717858]
[17] Neviaser TJ. Adhesive capsulitis. Orthop Clin North Am 1987; 18(3): 439-43.
[PMID: 3441364]
[18] van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol 1995; 48(5): 691-704.
[http://dx.doi.org/10.1016/0895-4356(94)00170-U] [PMID: 7730924]
[19] Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011; 20(3): 502-14.
[http://dx.doi.org/10.1016/j.jse.2010.08.023] [PMID: 21167743]
[20] Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med 2010; 38(11): 2346-56.
[http://dx.doi.org/10.1177/0363546509348048] [PMID: 20110457]
[21] Binder A, Hazleman BL, Parr G, Roberts S. A controlled study of oral prednisolone in frozen shoulder. Br J Rheumatol 1986; 25(3): 288-92.
[http://dx.doi.org/10.1093/rheumatology/25.3.288] [PMID: 3730737]
[22] Blockey NJ, Wright JK, Kellgren JH. Oral cortisone therapy in periarthritis of the shoulder; a controlled trial. BMJ 1954; 1(4877): 1455-7.
[http://dx.doi.org/10.1136/bmj.1.4877.1455] [PMID: 13160496]
[23] Kessel L, Bayley I, Young A. The upper limb: the frozen shoulder. Br J Hosp Med 1981; 25(4) 334, 336-7, 339.
[PMID: 7236953]
[24] Buchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(11): 1460-9.
[http://dx.doi.org/10.1136/ard.2003.018218] [PMID: 15479896]
[25] Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; 1(1): CD007005.
[PMID: 18254123]
[26] Favejee MM, Huisstede BM, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventionssystematic review. Br J Sports Med 2011; 45(1): 49-56.
[http://dx.doi.org/10.1136/bjsm.2010.071431] [PMID: 20647296]
[27] Tveita EK, Tariq R, Sesseng S, Juel NG, Bautz-Holter E. Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord 2008; 9: 53.
[http://dx.doi.org/10.1186/1471-2474-9-53] [PMID: 18423042]
[28] Griesser MJ, Harris JD, Campbell JE, Jones GL. Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. J Bone Joint Surg Am 2011; 93(18): 1727-33.
[http://dx.doi.org/10.2106/JBJS.J.01275] [PMID: 21938377]
[29] Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am 2006; 37(4): 531-9.
[http://dx.doi.org/10.1016/j.ocl.2006.09.009] [PMID: 17141009]
[30] Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract 2007; 57(541): 662-7.
[PMID: 17688763]
[31] Lorbach O, Anagnostakos K, Scherf C, Seil R, Kohn D, Pape D. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg 2010; 19(2): 172-9.
[http://dx.doi.org/10.1016/j.jse.2009.06.013] [PMID: 19800262]
[32] Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP. Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg 2011; 20(7): 1034-40.
[http://dx.doi.org/10.1016/j.jse.2011.04.029] [PMID: 21816628]
[33] Lee HJ, Lim KB, Kim DY, Lee KT. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Arch Phys Med Rehabil 2009; 90(12): 1997-2002.
[http://dx.doi.org/10.1016/j.apmr.2009.07.025] [PMID: 19969160]
[34] Naredo E, Cabero F, Beneyto P, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol 2004; 31(2): 308-14.
[PMID: 14760802]
[35] Sethi PM, Kingston S, Elattrache N. Accuracy of anterior intra-articular injection of the glenohumeral joint. Arthroscopy 2005; 21(1): 77-80.
[http://dx.doi.org/10.1016/j.arthro.2004.09.009] [PMID: 15650670]
[36] Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. Arthroscopy 2002; 18(8): 887-91.
[http://dx.doi.org/10.1053/jars.2002.35263] [PMID: 12368787]
[37] Juel NG, Oland G, Kvalheim S, Løve T, Ekeberg OM. Adhesive capsulitis: one sonographic-guided injection of 20 mg triamcinolon into the rotator interval. Rheumatol Int 2013; 33(6): 1547-53.
[http://dx.doi.org/10.1007/s00296-012-2503-4] [PMID: 23263492]
[38] Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 2006; 26(6): 536-40.
[http://dx.doi.org/10.1007/s00296-005-0022-2] [PMID: 16091920]
[39] Carette S, Moffet H, Tardif J, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum 2003; 48(3): 829-38.
[http://dx.doi.org/10.1002/art.10954] [PMID: 12632439]
[40] Ryans I, Montgomery A, Galway R, Kernohan WG, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford) 2005; 44(4): 529-35.
[http://dx.doi.org/10.1093/rheumatology/keh535] [PMID: 15657070]
[41] Iwata H. Pharmacologic and clinical aspects of intraarticular injection of hyaluronate. Clin Orthop Relat Res 1993; 199(289): 285-91.
[PMID: 8472428]
[42] Moskowitz RW, Blaine TA. An overview of treatment options for persistent shoulder pain. Am J Orthop 2005; 34(12)(Suppl.): 10-5.
[PMID: 16450691]
[43] Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg Am 2008; 90(5): 970-9.
[http://dx.doi.org/10.2106/JBJS.F.01116] [PMID: 18451387]
[44] Harris JD, Griesser MJ, Copelan A, Jones GL. Treatment of adhesive capsulitis with intra-articular hyaluronate: A systematic review. Int J Shoulder Surg 2011; 5(2): 31-7.
[http://dx.doi.org/10.4103/0973-6042.83194] [PMID: 21897581]
[45] Hsieh LF, Hsu WC, Lin YJ, Chang HL, Chen CC, Huang V. Addition of intra-articular hyaluronate injection to physical therapy program produces no extra benefits in patients with adhesive capsulitis of the shoulder: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93(6): 957-64.
[http://dx.doi.org/10.1016/j.apmr.2012.01.021] [PMID: 22502793]
[46] Wilson J, Russell S, Walton M. The management of frozen shoulder. Curr Phys Med Rehabil Rep 2015; 3: 181-7.
[http://dx.doi.org/10.1007/s40141-015-0090-5]
[47] DOrsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a review. Muscles Ligaments Tendons J 2012; 2(2): 70-8.
[PMID: 23738277]
[48] Vermeulen HM, Rozing PM, Obermann WR, le Cessie S, Vliet Vlieland TP. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther 2006; 86(3): 355-68.
[PMID: 16506872]
[49] Jewell DV, Riddle DL, Thacker LR. Interventions associated with an increased or decreased likelihood of pain reduction and improved function in patients with adhesive capsulitis: a retrospective cohort study. Phys Ther 2009; 89(5): 419-29.
[http://dx.doi.org/10.2522/ptj.20080250] [PMID: 19270045]
[50] Paul A, Rajkumar JS, Peter S, Lambert L. Effectiveness of sustained stretching of the inferior capsule in the management of a frozen shoulder. Clin Orthop Relat Res 2014; 472(7): 2262-8.
[http://dx.doi.org/10.1007/s11999-014-3581-2] [PMID: 24664198]
[51] Johnson AJ, Godges JJ, Zimmerman GJ, Ounanian LL. The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis. J Orthop Sports Phys Ther 2007; 37(3): 88-99.
[http://dx.doi.org/10.2519/jospt.2007.2307] [PMID: 17416123]
[52] Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther 2013; 43(5): A1-A31.
[http://dx.doi.org/10.2519/jospt.2013.0302] [PMID: 23636125]
[53] Diercks RL, Stevens M. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg 2004; 13(5): 499-502.
[http://dx.doi.org/10.1016/j.jse.2004.03.002] [PMID: 15383804]
[54] Russell S, Jariwala A, Conlon R, Selfe J, Richards J, Walton M. A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. J Shoulder Elbow Surg 2014; 23(4): 500-7.
[http://dx.doi.org/10.1016/j.jse.2013.12.026] [PMID: 24630545]
[55] Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol 2014; 33(5): 593-600.
[http://dx.doi.org/10.1007/s10067-013-2464-3] [PMID: 24374758]
[56] Wertheim HM, Rovenstime FA. Suprascapular nerve block. Anesthesiology 1941; 2: 541-5.
[http://dx.doi.org/10.1097/00000542-194109000-00006]
[57] Wassef MR. Suprascapular nerve block. A new approach for the management of frozen shoulder. Anaesthesia 1992; 47(2): 120-4.
[http://dx.doi.org/10.1111/j.1365-2044.1992.tb02007.x] [PMID: 1539779]
[58] Jones DS, Chattopadhyay C. Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial. Br J Gen Pract 1999; 49(438): 39-41.
[PMID: 10622015]
[59] Dahan TH, Fortin L, Pelletier M, Petit M, Vadeboncoeur R, Suissa S. Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol 2000; 27(6): 1464-9.
[PMID: 10852272]
[60] Børglum J, Bartholdy A, Hautopp H, Krogsgaard MR, Jensen K. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review. Acta Anaesthesiol Scand 2011; 55(2): 242-7.
[http://dx.doi.org/10.1111/j.1399-6576.2010.02370.x] [PMID: 21226866]
[61] Andren L, Lundberg BJ. Treatment of rigid shoulders by joint distension during arthrography. Acta Orthop Scand 1965; 36: 45-53.
[http://dx.doi.org/10.3109/17453676508989370] [PMID: 14308098]
[62] Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1): 25-35.
[PMID: 17987207]
[63] Corbeil V, Dussault RG, Leduc BE, Fleury J. Adhesive capsulitis of the shoulder: a comparative study of arthrography with intra-articular corticotherapy and with or without capsular distension. Can Assoc Radiol J 1992; 43(2): 127-30.
[PMID: 1562888]
[64] Jacobs LG, Barton MA, Wallace WA, Ferrousis J, Dunn NA, Bossingham DH. Intra-articular distension and steroids in the management of capsulitis of the shoulder. BMJ 1991; 302(6791): 1498-501.
[http://dx.doi.org/10.1136/bmj.302.6791.1498] [PMID: 1855018]
[65] Gam AN, Schydlowsky P, Rossel I, Remvig L, Jensen EM. Treatment of frozen shoulder with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. Scand J Rheumatol 1998; 27(6): 425-30.
[http://dx.doi.org/10.1080/030097498442244] [PMID: 9855212]
[66] Hsu SY, Chan KM. Arthroscopic distension in the management of frozen shoulder. Int Orthop 1991; 15(2): 79-83.
[http://dx.doi.org/10.1007/BF00179702] [PMID: 1917198]
[67] Clement RG, Ray AG, Davidson C, Robinson CM, Perks FJ. Frozen shoulder : long-term outcome following arthrographic distension. Acta Orthop Belg 2013; 79(4): 368-74.
[PMID: 24205764]
[68] Watson L, Bialocerkowski A, Dalziel R, Balster S, Burke F, Finch C. Hydrodilatation (distension arthrography): a long-term clinical outcome series. Br J Sports Med 2007; 41(3): 167-73.
[http://dx.doi.org/10.1136/bjsm.2006.028431] [PMID: 17178772]
[69] Park KD, Nam HS, Lee JK, Kim YJ, Park Y. Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil 2013; 94(2): 264-70.
[http://dx.doi.org/10.1016/j.apmr.2012.10.002] [PMID: 23063625]
[70] Grant JA, Schroeder N, Miller BS, Carpenter JE. Comparison of manipulation and arthroscopic capsular release for adhesive capsulitis: a systematic review. J Shoulder Elbow Surg 2013; 22(8): 1135-45.
[http://dx.doi.org/10.1016/j.jse.2013.01.010] [PMID: 23510748]
[71] Farrell CM, Sperling JW, Cofield RH. Manipulation for frozen shoulder: long-term results. J Shoulder Elbow Surg 2005; 14(5): 480-4.
[http://dx.doi.org/10.1016/j.jse.2005.02.012] [PMID: 16194738]
[72] Wang JP, Huang TF, Ma HL, Hung SC, Chen TH, Liu CL. Manipulation under anaesthesia for frozen shoulder in patients with and without non-insulin dependent diabetes mellitus. Int Orthop 2010; 34(8): 1227-32.
[http://dx.doi.org/10.1007/s00264-010-0968-x] [PMID: 20157810]
[73] Jacobs LG, Smith MG, Khan SA, Smith K, Joshi M. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg 2009; 18(3): 348-53.
[http://dx.doi.org/10.1016/j.jse.2009.02.002] [PMID: 19393928]
[74] Kivimäki J, Pohjolainen T, Malmivaara A, et al. Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: a randomized, controlled trial with 125 patients. J Shoulder Elbow Surg 2007; 16(6): 722-6.
[http://dx.doi.org/10.1016/j.jse.2007.02.125] [PMID: 17931902]
[75] De Carli A, Vadalà A, Perugia D, et al. Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections? Int Orthop 2012; 36(1): 101-6.
[http://dx.doi.org/10.1007/s00264-011-1330-7] [PMID: 21833684]
[76] Reichmister JP, Friedman SL. Long-term functional results after manipulation of the frozen shoulder. Md Med J 1999; 48(1): 7-11.
[PMID: 10048277]
[77] Harryman DT II, Matsen FA III, Sidles JA. Arthroscopic management of refractory shoulder stiffness. Arthroscopy 1997; 13(2): 133-47.
[http://dx.doi.org/10.1016/S0749-8063(97)90146-8] [PMID: 9127069]
[78] Beaufils P, Prévot N, Boyer T, et al. Arthroscopic release of the glenohumeral joint in shoulder stiffness: a review of 26 cases. Arthroscopy 1999; 15(1): 49-55.
[http://dx.doi.org/10.1053/ar.1999.v15.0150041] [PMID: 10024033]
[79] Smith CD, Hamer P, Bunker TD. Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation. Ann R Coll Surg Engl 2014; 96(1): 55-60.
[http://dx.doi.org/10.1308/003588414X13824511650452] [PMID: 24417832]
[80] Walther M, Blanke F, Von Wehren L, Majewski M. Frozen shouldercomparison of different surgical treatment options. Acta Orthop Belg 2014; 80(2): 172-7.
[PMID: 25090788]
[81] Ogilvie-Harris DJ, Wiley AM. Arthroscopic surgery of the shoulder. A general appraisal. J Bone Joint Surg Br 1986; 68(2): 201-7.
[PMID: 3958003]
[82] Le Lievre HM, Murrell GA. Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 2012; 94(13): 1208-16.
[http://dx.doi.org/10.2106/JBJS.J.00952] [PMID: 22760389]
[83] Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009; 25(1): 19-23.
[http://dx.doi.org/10.1016/j.arthro.2008.08.006] [PMID: 19111214]
[84] Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. J Shoulder Elbow Surg 2004; 13(2): 180-5.
[http://dx.doi.org/10.1016/j.jse.2003.12.004] [PMID: 14997096]
[85] Holloway GB, Schenk T, Williams GR, Ramsey ML, Iannotti JP. Arthroscopic capsular release for the treatment of refractory postoperative or post-fracture shoulder stiffness. J Bone Joint Surg Am 2001; 83-A(11): 1682-7.
[http://dx.doi.org/10.2106/00004623-200111000-00010] [PMID: 11701791]
[86] Baums MH, Spahn G, Nozaki M, Steckel H, Schultz W, Klinger HM. Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis. Knee Surg Sports Traumatol Arthrosc 2007; 15(5): 638-44.
[http://dx.doi.org/10.1007/s00167-006-0203-x] [PMID: 17031613]
[87] Liem D, Meier F, Thorwesten L, Marquardt B, Steinbeck J, Poetzl W. The influence of arthroscopic subscapularis tendon and capsule release on internal rotation strength in treatment of frozen shoulder. Am J Sports Med 2008; 36(5): 921-6.
[http://dx.doi.org/10.1177/0363546507313090] [PMID: 18272795]
[88] Pearsall AW IV, Osbahr DC, Speer KP. An arthroscopic technique for treating patients with frozen shoulder. Arthroscopy 1999; 15(1): 2-11.
[http://dx.doi.org/10.1053/ar.1999.v15.0150002] [PMID: 10024027]
[89] Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral jointindication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 178-86.
[http://dx.doi.org/10.1007/s001670100194] [PMID: 11420793]
[90] Jerosch J, Nasef NM, Peters O, Mansour AM. Mid-term results following arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis. Knee Surg Sports Traumatol Arthrosc 2013; 21(5): 1195-202.
[http://dx.doi.org/10.1007/s00167-012-2124-1] [PMID: 22763569]
[91] Lafosse L, Boyle S, Kordasiewicz B, Aranberri-Gutiérrez M, Fritsch B, Meller R. Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy 2012; 28(7): 916-23.
[http://dx.doi.org/10.1016/j.arthro.2011.12.014] [PMID: 22421567]
[92] Chen J, Chen S, Li Y, Hua Y, Li H. Is the extended release of the inferior glenohumeral ligament necessary for frozen shoulder? Arthroscopy 2010; 26(4): 529-35.
[http://dx.doi.org/10.1016/j.arthro.2010.02.020] [PMID: 20362834]
[93] Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M. The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res 1995; (319): 238-48.
[PMID: 7554636]
[94] Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 1989; 71(10): 1511-5.
[http://dx.doi.org/10.2106/00004623-198971100-00009] [PMID: 2592391]
[95] Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 2001; 10(4): 353-7.
[http://dx.doi.org/10.1067/mse.2001.115986] [PMID: 11517365]
[96] Buchbinder R, Youd JM, Green S, et al. Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: a randomized trial. Arthritis Rheum 2007; 57(6): 1027-37.
[http://dx.doi.org/10.1002/art.22892] [PMID: 17665470]
[97] Maund E, Craig D, Suekarran S, et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess 2012; 16(11): 1-264.
[http://dx.doi.org/10.3310/hta16110] [PMID: 22405512]
[98] Wong PL, Tan HC. A review on frozen shoulder. Singapore Med J 2010; 51(9): 694-7.
[PMID: 20938608]
[99] Karataş GK, Meray J. Suprascapular nerve block for pain relief in adhesive capsulitis: comparison of 2 different techniques. Arch Phys Med Rehabil 2002; 83(5): 593-7.
[http://dx.doi.org/10.1053/apmr.2002.32472] [PMID: 11994796]
[100] Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. J Shoulder Elbow Surg 2005; 14(1): 16-21.
[http://dx.doi.org/10.1016/j.jse.2004.04.004] [PMID: 15723009]
[101] Rookmoneea M, Dennis L, Brealey S, et al. The effectiveness of interventions in the management of patients with primary frozen shoulder. J Bone Joint Surg Br 2010; 92(9): 1267-72.
[http://dx.doi.org/10.1302/0301-620X.92B9.24282] [PMID: 20798446]
[102] Dennis L, Brealey S, Rangan A, et al. Managing idiopathic frozen shoulder: a survey of health professionals' current practice and research priorities. Shoulder Elbow 2010; 2: 294-300.
[http://dx.doi.org/10.1111/j.1758-5740.2010.00073.x]
[103] Kwaees TA, Charalambous CP. Surgical and non-surgical treatment of frozen shoulder. Survey on surgeons treatment preferences. Muscles Ligaments Tendons J 2015; 4(4): 420-4.
[PMID: 25767778]

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