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Hands-on physical therapy are effective for a shoulder condition


Condition lasts at least one year and consists of three phases


Adhesive capsulitis, commonly called frozen shoulder, is a condition that causes pain, stiffness, and loss of motion in the shoulder. It occurs in about 2-5% of the population and is most common in people between the ages of 40-60. Frozen shoulder lasts approximately 12-42 months, and consists of three phases. It starts with a painful phase lasting 2-9 months, which is followed by a stiff phase for 3-12 months in which the shoulder becomes very stiff and difficult to move. The last of these is the healing, or thawing phase, in which patients regain their movement and function over the course of 5-26 months. Physical therapy is commonly used to treat frozen shoulder, and one of the techniques used by physical therapists is called mobilization. This consists of various hands-on movements applied to the shoulder to increase its flexibility and reduce pain. Although mobilizations are frequently used, it's not clear how effective they are and which techniques are best. For this reason, a powerful type of study called a systematic review was conducted. The review collected all available literature on the topic to determine which mobilization technique was most effective for frozen shoulder.


A total of 12 studies are accepted for the review


Researchers performed a search using two medical databases for any studies that looked into different mobilization techniques to treat frozen shoulder. A total of 12 studies with data on 810 patients fit the necessary criteria and were included in the systematic review. Seven different types of mobilization techniques were evaluated, and the main patient outcomes measured were pain and range of motion, which is a measure of how much they could move their shoulder. The data from all of these studies was evaluated in depth, and their quality was also assessed to determine how reliable their findings were.


A combination of a few types of techniques is most effective for frozen shoulder


On the whole, mobilization techniques were found to be beneficial for patients with frozen shoulder. A combination of one approach called the Maitland technique with the mobilization of the spine and shoulder stretching appears to be best for reducing pain and improving shoulder flexibility. For this reason, this combination of techniques is recommended for patients with frozen shoulder; however, there was not enough information on many of the other mobilization techniques in the review. Therefore, additional research is needed to investigate these other techniques in more detail so it can be more clearly determined which is the best for treating frozen shoulder. While this process takes place, patients with frozen shoulder should acknowledge that mobilization techniques performed by physical therapists are generally helpful for reducing pain and increasing the flexibility of their shoulder.


-As reported in the August '16 issue of the Archives of Physical Medicine and Rehabilitation
August 30, 2017