Frozen shoulder syndrome: diagnostic and treatment strategies in the primary care setting

Abstract

The term “frozen shoulder” has been used to describe an array of clinical conditions. The authors consider a patient as meeting the criteria of primary or secondary frozen shoulder syndrome if he/she has a clinical history of worsening painful shoulder motion loss of at least 1 month duration and a physical examination documenting painful restricted shoulder motion. In the evaluation of the patient with suspected FSS, initial screening shoulder radiographs are required to exclude other conditions. The physical examination of the frozen shoulder patient should include observation, cervical examination, assessment of range of motion, and the use of provocative testing. The treatment of the patient with FSS should include preventative education, various medications including NSAIDS and oral corticosteroids, physical therapy, and finally, for the patient with refractory symptoms, surgical intervention. For those patients necessitating surgical intervention, the authors recommend a selective arthroscopic capsular release.