This prospective RCT enrolled 42 patients with defined frozen shoulder. All were taught pendular exercises, then randomized to intraarticular/subacromial steroids, Maitland mobilisation, ice with PNF, or no treatment. It asks whether any regimen outperforms natural recovery over eight months of blinded follow-up.
The clinical rule from this paper: treat frozen shoulder as a self-limiting condition, and use steroid injection to control the painful early phase rather than to change the ultimate outcome. All four groups, including no treatment, ended up in roughly the same place by eight months. The steroid advantage was real but confined to the first six weeks.
Because most recovery occurs within four weeks, prolonged physiotherapy adds little. If you use it, cap the course at about four weeks. A key teaching point for the exam and the clinic: patients routinely report they have recovered while 90% still have measurable range deficit at six months. Always document objective range rather than trusting subjective recovery.
No clinical feature (dominance, traumatic vs spontaneous onset, baseline severity) predicted outcome, so avoid over-promising or over-treating based on presentation.
This prospective RCT enrolled 42 patients with defined frozen shoulder. All were taught pendular exercises, then randomized to intraarticular/subacromial steroids, Maitland mobilisation, ice with PNF, or no treatment. It asks whether any regimen outperforms natural recovery over eight months of blinded follow-up.
The clinical rule from this paper: treat frozen shoulder as a self-limiting condition, and use steroid injection to control the painful early phase rather than to change the ultimate outcome. All four groups, including no treatment, ended up in roughly the same place by eight months. The steroid advantage was real but confined to the first six weeks.
Because most recovery occurs within four weeks, prolonged physiotherapy adds little. If you use it, cap the course at about four weeks. A key teaching point for the exam and the clinic: patients routinely report they have recovered while 90% still have measurable range deficit at six months. Always document objective range rather than trusting subjective recovery.
No clinical feature (dominance, traumatic vs spontaneous onset, baseline severity) predicted outcome, so avoid over-promising or over-treating based on presentation.