One article on PainSci cites Hanchard 2011: Complete Guide to Frozen Shoulder
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: To gain insights into the diagnosis and management of contracted (frozen) shoulder (CFS) in a sample of UK physiotherapists, underpinning the development of evidence-based clinical guidelines.
METHODS: An anonymous online questionnaire was developed and distributed via iCSP, targeting physiotherapists who treat CFS. For treatments, respondents were invited to consider 'pain-predominant' and 'stiffness-predominant' scenarios, choose from listed treatment options, and specify any unlisted conservative options they might consider. Frequency analysis was used for closed-ended questions, and content analysis was used for open-ended questions.
RESULTS: In total, 289 valid responses were received. All respondents thought that movement restriction informed diagnosis. Of those specifying the manner of testing movements, 98% (121/123) included passive testing. Of those describing specific patterns of restriction, 71% (93/131) emphasised external rotation. Fifty-four percent (152/282) of valid respondents would consider suggesting/requesting imaging investigations, usually to exclude bony abnormalities. For treatment, only 46 respondents reported considering any unlisted conservative options, usually liaison regarding medication. For pain-predominant CFS, the preferred physiotherapeutic options were advice/education (96%; 277/288), injection (80%; 230/288), gentle exercise (79%; 228/288), superficial heat/cold (69%; 199/288) and acupuncture (68%; 196/288). For stiffness-predominant CFS, the preferred options were stretching (93%; 268/288), advice/education (88%; 252/288), joint mobilisations (87%; 250/288), function-based exercises (75%; 216/288) and hands-on soft-tissue techniques (59%; 170/288). Some dissociation was noted between clinical practice and research evidence. Eighty-five percent (253/284) of respondents would consider referring for an orthopaedic opinion.
CONCLUSIONS: Acknowledging restricted passive external rotation (vs the capsular pattern) as diagnostic of CFS would standardise and might improve the clinical aspect of diagnosis. The value of X-rays in differential diagnosis was under-recognised. Modalities used to treat CFS were dichotomised by pain-predominant and stiffness-predominant classifications, which may be more useful than existing classifications.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.