Communication
Treatment Strategy for Shoulder Periarthritis in Painful Phase and Frozen Phase
Issue:
Volume 1, Issue 2, June 2025
Pages:
34-37
Received:
2 July 2025
Accepted:
19 July 2025
Published:
7 August 2025
Abstract: Scapulohumeral periarthritis, more commonly known as “frozen shoulder (FS)”, is a painful shoulder condition with significant decrease of active and passive range of motion. The illness progresses through three phases: freezing (painful phase), frozen and thawing. The goal of any treatment is to reduce pain and restore shoulder movement. oral anti-inflammatory and analgesic medications and steroid injections in trigger point has been successful in improving pain relief, reducing disability, and increasing range of motion in subjects with stage 1 and 2 periarthritis. Nonsteroidal anti-inflammatory and analgesic medications should be administered throughout whole treatment process. COX-2 inhibitors such as Etoricoxib and Celecoxib should be first chosen. Manipulation under anesthesia (MUA) should be performed during the frozen phase. MUA is performed under brachial plexus anesthesia or intravenous general anesthesia. SSNB (suprascapular nerve block) is superior to IACI (intra-articular corticosteroid injections) for FS. The use of steroids is limited to inject at trigger points, and the dosage should not be excessive to reduce side effects. ACR（Arthroscopic capsular release）has now replaced open surgery with joint capsule release. ACR is a relatively new technique that allows partial or complete release of the joint capsule under arthroscopic visualization. ACR should be performed for refractory or recurrence FS after MUA during the frozen phase. Only when the inflammation around the shoulder is suppressed by oral administration of nonsteroidal anti-inflammatory and analgesic drugs and injection of targeted corticosteroids, shoulder exercises will be effective.
Abstract: Scapulohumeral periarthritis, more commonly known as “frozen shoulder (FS)”, is a painful shoulder condition with significant decrease of active and passive range of motion. The illness progresses through three phases: freezing (painful phase), frozen and thawing. The goal of any treatment is to reduce pain and restore shoulder movement. oral anti-...
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