Publication:

Medical versus surgical management of frozen shoulder: a prospective observational comparative study at 6 months

Background Frozen shoulder is characterized by pain and progressive restriction of shoulder movement. Conservative treatment is commonly used initially, whereas surgery is considered in selected patients with persistent or severe functional limitation. This study compared outcomes after medical and surgical management at 6 months.

Methods This prospective observational study included 70 patients with frozen shoulder: 50 received corticosteroid injection with physiotherapy and 20 underwent arthroscopic capsular release followed by physiotherapy. Range of motion (ROM), Constant-Murley score (CMS), DASH score and patient satisfaction were assessed at baseline and 6 months.

Results Both groups improved significantly at 6 months (p<0.001). CMS improvement was greater in the surgical group than in the medical group (43.05±11.95 vs 25.86±10.05; p<0.001), and DASH reduction was greater after surgery (-38.95±12.57 vs -29.48±13.26; p=0.010). Surgical treatment was associated with greater gains in flexion, abduction and external rotation and higher patient satisfaction (8.45±1.19 vs 6.42±1.16; p<0.001). Similar differences were observed in patients in the freezing and frozen stages.

Conclusions Both modalities were associated with significant functional improvement at 6 months. In this non-randomized cohort, surgical management was associated with greater improvement in ROM and functional scores, particularly in patients with severe disease.