Editor’s note: This post has been left available to view, as an example of our experiments with sharing evidence in creative ways, but please note that, unlike our normal blogs, it has not been updated and so may not represent the latest Cochrane evidence.
Frozen shoulder (adhesive capsulitis): it’s not just snowmen
Frozen shoulder, or adhesive capsulitis, is a common cause of shoulder stiffness and pain and can last for two or three years. There’s evidence from two recently updated Cochrane reviews on whether electrotherapy or manual therapy and exercise can help.
High quality evidence showed that:
- following arthrographic joint distension, the combination of manual therapy and exercise does not improve pain or function more than sham ultrasound, but may provide greater patient-reported treatment success and active range of motion
Moderate or low quality evidence suggested that:
- low level laser therapy (LLLT) plus exercise for eight weeks may be more effective than exercise alone in terms of pain up to four weeks, and function up to four months
- LLLT for six days may be more effective than placebo in terms of overall treatment success at six days
- it is unclear whether pulsed electromagnetic field therapy is more or less effective than placebo, or whether other electrotherapies are an effective addition to exercise
- manual therapy and exercise probably improves pain and function less than glucocorticoid injection up to seven weeks
- side effects were similar with manual therapy and exercise compared with glucocorticoid injection
More high quality randomised controlled trials are needed to establish the benefits and harms of electrotherapy, manual therapy and exercise compared to interventions with evidence of benefit, such as glucocorticoid injection or arthrographic joint distension.
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Page MJ, Green S, Kramer S, Johnston RV, McBain B, Buchbinder R. Electrotherapy modalities for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD011324. DOI: 10.1002/14651858.CD011324 – See more at: http://summaries.cochrane.org/CD011324/MUSKEL_electrotherapy-modalities-for-adhesive-capsulitis-frozen-shoulder#sthash.j8cGivfj.dpuf
Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews 2014, Issue 8. Art. No.: CD011275. DOI: 10.1002/14651858.CD011275 – See more at: http://summaries.cochrane.org/CD011275/MUSKEL_manual-therapy-and-exercise-for-frozen-shoulder-adhesive-capsulitis#sthash.HtjuvQp5.dpuf