Manipulation in the treatment of frozen shoulder

The treatment of frozen shoulder has been an area of controversy in orthopedics for many years. The natural history of this condition would indicate that most patients recover painless range of motion of the shoulder by 2 years after the onset of symptoms. However, work and economic pressures often make it important to establish a treatment program that can enable these patients to return to a functional, painless range of motion as soon as possible. In this retrospective study, 17 frozen shoulders in 15 patients who did not respond to physical therapy were manipulated. Of those patients not able to work prior to their shoulder problems, 70% had returned to work within an average of 2.6 months of manipulation. All of the patients in this study had a significant improvement in shoulder flexion and abduction, returning to a functional range of shoulder motion. Manipulation allowed the patients studied to return to a normal lifestyle and to work much sooner than the reported natural history of this condition would indicate.