Non-Surgical Management of Frozen Shoulder Using Manipulation Under Local Anesthesia: A Retrospective Study

BACKGROUND The literature contains no standard management guideline for the treatment of frozen shoulder (FS). Our aim in this study was to increase the shoulder joint range of motion (ROM) by performing passive shoulder manipulation on the affected shoulder under local anesthesia in patients with FS. MATERIAL AND METHODS Thirty-two adult patients who applied to the orthopedics and traumatology clinic between 2019 and 2022 and were diagnosed with FS were included in the study. This was a retrospective study without a control group. Approximately 20 cc (19 cc 2% prilocaine +1 cc 40 mg methylprednisolone acetate) mixture was injected into the affected shoulder of the patients at 6 different points. After an average of 15 minutes, passive manipulation was applied to the affected shoulder in 4 different directions. After manipulation, the patients were kept under observation for a certain period of time to assess for complications. Patients were given home exercise programs. During the treatment process, the patients were called for control at regular intervals and were followed up for 3 months. In this time interval, visual analog scale (VAS), shoulder pain and disability index (SPADI), and ROM values were recorded before and after manipulation and at the last check (LC). RESULTS During the treatment follow-up, ROM (abduction, flexion, extension, external rotation) values increased (P<0.001). A significant improvement was observed in SPADI and VAS values (P<0.001). CONCLUSIONS The manipulation method under local anesthesia is a time-saving, cost-effective treatment that eliminates hospitalization, general analgesia, or sedoanalgesia in the treatment of FS patients.