Comprehensive Analysis of Frozen Shoulder Management

BACKGROUND: Frozen shoulder (FS) is a painful and debilitating condition characterized by progressive stiffness and restricted shoulder movement. It primarily affects middle-aged individuals, with a higher prevalence in women and those with metabolic disorders such as diabetes and hypertension. While FS is self-limiting, lasting 1-3 years, timely medical management with physiotherapy and interventions can accelerate recovery. This study evaluates the demographic profile, comorbidities, and treatment outcomes of FS patients managed at a pain clinic over four years. METHODS: This retrospective cross-sectional study included patients with frozen shoulder during the painful phase, treated at Nepal Pain Care and Research Center (Oct 2020-Oct 2024). Conservative treatment included analgesics (NASIDs and Paracetamol), Duloxetine, and physiotherapy. Non-responders underwent ultrasound-guided hydrodistension with 5% dextrose, lignocaine, methylprednisolone, and suprascapular block. Outcomes were assessed based on pain reduction, shoulder mobility, and daily function. RESULTS: All 112 patients with frozen shoulder were initially treated with conservative management. Out of these, 100 patients (89.3%) showed significant improvement. However, 12 patients (10.7%) did not respond well to conservative treatment and were therefore ultrasound-guided hydrodistension was done. Among them, 10 patients (83.3%) experienced noticeable improvement, while 2 patients (16.7%) reported reduced pain but no improvement in their range of motion. CONCLUSIONS: Conservative treatments proved effective in most cases (89.3%), while ultrasound-guided hydrodistension was beneficial for resistant cases (83.3%).