What is the prognosis and expected outcomes for different frozen shoulder syndrome (FSS) (adhesive capsulitis) treatments?

Updated: Nov 12, 2020
  • Author: Jefferson R Roberts, MD; Chief Editor: S Ashfaq Hasan, MD  more...
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Answer

FSS has a favorable natural history. It is generally a self-limiting condition that can be treated with physical therapy and typically resolves in 1-3 years. [38] Time to recovery does not differ between primary and secondary FSS. No difference in pain and disability of FSS in patients with and without diabetes has been reported. [39] Patients with FSS do not have a lower shoulder activity level than sex- and age-matched controls. [40]

However, several studies have demonstrated long-term pain and shoulder stiffness following conservative treatment. Long-term disability has been reported in 15%, [8] permanent functional loss in 7-15%, and persistent symptoms in 40%. [41]

Several studies have noted improved symptoms following arthroscopic capsular release, as follows:

  • Warner and colleagues reported an improvement in the Constant and Murley score of 48 points with a mean follow-up of 39 months. [76]
  • Pearsall and colleagues found that 83% of patients reported their shoulder to be normal or near normal at an average of 22 months following capsular release. [77]
  • Ogilvie-Harris noted that 15 of 18 patients treated with arthroscopic capsular release had an excellent result at 2-5 years following surgery.
  • A review of the literature indicates that in patients with refractory adhesive capsulitis, a near-excellent to excellent result in 75-90% of cases can be expected in patients treated with arthroscopic capsular release and an aggressive postoperative physical therapy regimen.

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