Current concepts of natural course and in management of frozen shoulder: A clinical overview

Abstract

Frozen Shoulder (FS) by many specialists is still considered a benign, self-limiting condition, which usually resolves without intervention. This concept originated in the 70’, stating that FS will proceed from “the freezing” phase, with the predominance of inflammation and pain to “the frozen” phase with marked stiffness in the joint and “the thawing” phase, with a progressive return to the normal Range Of Motion (ROM) and function. Nevertheless, numerous authors have recently challenged this concept, arguing that most patients with FS will never fully recover, and suffer from residual pain and loss of function. Lack of early intervention, when a patient does not improve with conservative treatment, might lead to disability. We have discussed the recent concepts in the natural course of the disease and discussed both noninvasive and surgical methods in the treatment of FS.

Human bone marrow mesenchymal stem cell-derived extracellular vesicles inhibit shoulder stiffness via let-7a/Tgfbr1 axis

“…First, we just utilized the adult mice model to study the effects of BMSC-EVs on capsular fibrosis. However, SS is complex in pathogenesis and multi-factor in clinical practice [ 73 ]. Further study should consider verifying the therapeutic effects of BMSC-EVs in other animal models.…”

Comparison of functional outcome of intra-articular steroid injection versus steroid injection in rotator interval in the treatment of early frozen shoulder

“…Adhesive capsulitis (AC) is a frozen painful shoulder disease that lasts more than three months, is also known as frozen shoulder. The glenohumeral joint capsule fibrosis that results from this inflammatory disease is accompanied by substantial range of motion limitation and gradually advancing stiffness (typically external rotation) 11 . However, the patients can have a fast onset of symptoms and a protracted healing process.…”

“…More study was required to compare the functional outcomes of intra-articular steroid injection against steroid injection in the rotator interval in the treatment of early frozen shoulder in our local population due to the dearth of related studies 11 . The findings of this study will demonstrate better outcomes in terms of pain relief and a reduction in SPADI scores to be taken into consideration in patients with adhesive capsulitis in our local population, and will subsequently show the correct site of corticosteroid injection for the treatment of FS in our local population.…”

The role of suprascapular nerve block in hydrodilatation for frozen shoulder

“…Previous studies noted that the suprascapular nerve block and intra-articular steroid injection only improved short-term outcomes (2 months after intervention) in terms of pain reduction and improvement in functional scores of the affected shoulder and not in long-term outcomes (1 year after the intervention), evaluated with function VASs (pain VAS and function VAS, respectively), ASES score, the Korean shoulder scoring system, the constant score, the simple shoulder test, and the shoulder pain and disability index [22]. Being a self-limiting condition, the treatment of frozen shoulder is meant to be symptomatic [23].…”