Corticosteroids are used in some cases either through local injection or systemically. In the short term, intra-articular corticosteroid injections were more effective in pain alleviation. Unfortunately, this pain reduction was not long-lasting. In both the short and long term, intra-articular corticosteroid injections improved passive range of motion (ROM). Oral steroids may provide short-term benefits in range of movement and pain but have side effects such as hyperglycemia. Steroid injections compared to physical therapy have a similar effect in improving shoulder function and decreasing pain. The benefits of steroid injections appear to be short-term. The results of this study imply that using an IA corticosteroid early in individuals with frozen shoulder who have had it for less than a year had a better prognosis. To increase the chances of recovery, this treatment should be combined with a home exercise program. Oral corticosteroids should not be used consistently to treat adhesive capsulitis because of the dangers associated with long-term use and the lack of long-term benefit.The role for occupational therapy (OT) in adhesive capsulitis is dependent on restrictions on daily activities, pain, and limitations the person is experiencing; an occupational therapist usually makes an initial evaluation. Pain and limited joint mobility are primary complaints that impact a persons daily life. OT will usually start by using a preparatory method, like physical agent modalities to be used as part of a comprehensive occupational therapy program. The occupational therapist may teach strengthening exercises and provide a home exercise program.
Surgery to cut the adhesions (capsular release) may be indicated in prolonged and severe cases; the procedure is usually performed by arthroscopy. Surgical evaluation of other problems with the shoulder, e.g., subacromial bursitis or rotator cuff tear, may be needed. Resistant adhesive capsulitis may respond to open release surgery. This technique allows the surgeon to find and correct the underlying cause of restricted glenohumeral movement such as contracture of coracohumeral ligament and rotator interval. Physical therapy may achieve improved results after surgical procedure and postoperative rehabilitation.Physical therapy is an effective procedure that provides essential exercises to improve range of motion. Patients who receive the proper training from an authorized physiotherapist can perform these exercises independently at home. The physiotherapy treatment for frozen shoulder will include manual therapy to mobilize the affected joints and release their muscles. "Pendulum stretch", "finger walk", "towel stretch", "armpit stretch" and "crossbody reach" are some essential mobility exercises specifically designed to improve the shoulder mobility of patients with frozen shoulders. There are also limited case reports of therapy utilizing vibration platforms obtaining fast results, not as a post-operative aid, but instead of surgery.Acupuncture has been found to decrease pain levels and improve shoulder function and range of motion, particularly in shoulder flexion. Acupuncture combined with shoulder exercises was found to be more effective than shoulder exercise alone. However, further studies with longer follow-up times are needed to assess mid- and long term benefits. Prognosis
Most cases of adhesive capsulitis are self limiting, but may take 1 to 3 years to fully resolve.