The effectiveness of Ultrasound guided Hydrodistension and physiotherapy in the treatment of Frozen shoulder/Adhesive Capsulitis in Primary Care: a single centre service evaluation

Abstract

Background: Evidence for optimal non-operative treatment of frozen shoulder is lacking. The aim of this study is to evaluate a treatment strategy for stage II-III Frozen shoulder provided by the current primary care Musculoskeletal Service.

Methods: GP referrals of shoulder pain to the musculoskeletal service diagnosed with stage II-III frozen shoulder and who opted for a treatment strategy of hydrodistension and guided physiotherapy exercise programme over a 12 month period were evaluated for 6 months. Thirty three patients were diagnosed with stage II-III frozen shoulder by specialist physiotherapists and opted for the treatment strategy. Outcome measures included SPADI and QuickDASH, pain score and range of movement. Data was collected at baseline, 6 weeks, 12 weeks and 6 months.

Results: All patients significantly improved in shoulder symptoms on the SPADI and QuickDASH scores (p< 0.001). Pain scores and range of shoulder movement flexion, abduction, external rotation showed significant improvement at all time points (p<0.001).

Conclusions: This service evaluation demonstrates that management of frozen shoulder stage II-III, by physiotherapists in a primary care setting utilizing hydrodistension and guided exercise programme is an effective non-operative treatment strategy.
Level of evidence: Level III, Service evaluation.