Interprofessional collaborative project for the diagnosis, assessment, and treatment of contracted (frozen) shoulder

Abstract

Contracted (frozen) shoulder (CFS) is a condition characterized by decreased active and passive shoulder range of motion and pain. The etiology of CFS is unknown and even the diagnostic terminology has evolved. Some risk factors for developing this condition include diabetes, as well as, several other endocrine, cardiac, and neurologic disorders. The incidence of this condition is approximately 2% of the population; however, the diagnosis may have been overused for other painful and stiff shoulder conditions such as shoulder dislocation, glenohumeral osteoarthritis, and rotator cuff tears. The historical symptomatic distinction of three clinical phases may be less clinically useful than simply a “pain predominant” and “stiffness predominant” shoulder. With a gradual onset, an accurate diagnosis and appropriate intervention may accelerate pain relief. While there are non-operative and operative treatment options, the focus of this review is primarily non-operative treatments. The purpose of this project is to review up-to-date clinical practice guidelines for CFS with an inter-professional, collaborative work group of orthopaedic and physical therapy providers. The goal of this project is to develop and implement a treatment standard based on best practices for this condition.