Abstract
Shoulder stiffness is a condition of restricted glenohumeral range of motion, which
can arise spontaneously or as consequence of a known cause, including surgical procedures
on the shoulder. Several approaches to shoulder stiffness have been proposed and high-level
evidence is available to analyze and discuss their results. The aim of this review
was to summarize the current concepts on conservative and operative treatment of shoulder
stiffness and discuss the results of the available studies with a high level of evidence,
which should be considered to guide clinical practice. Treatment of shoulder stiffness
should be tailored to the patientʼs clinical situation and the stage of its shoulder
pathology and should aim at pain reduction, restoration of range of motion, functional
regain and shortening of symptoms duration. When possible, known risk factors for
primary shoulder stiffness and causes of secondary shoulder stiffness should be addressed
to avoid relapse. Conservative therapy is the mainstay of treatment for shoulder stiffness
and should include a multimodal and activity-oriented program. Intra-articular injection
of a low dose of corticosteroid is safe and effective, provides immediate benefits,
and is recommended in combination to an appropriate rehabilitation protocol. In conservative
refractory cases, arthrolysis and capsular release can be performed with an arthroscopic
approach.
Key words
shoulder stiffness - adhesive capsulitis - frozen shoulder - treatment algorithm -
results
