29/09/2025
A 58-year-old female patient presents with a 6-month history of progressive shoulder pain and stiffness. She reports difficulty in moving her arm overhead and in rotating her arm medially. On examination, her shoulder has limited range of motion (ROM), with the most significant restriction in internal rotation. She has no history of trauma, and her blood tests are normal.
A. Immediate surgical intervention
B. A structured physiotherapy program focusing on passive stretching and mobilization
C. Use of a shoulder brace to restrict movement
D. Administration of corticosteroid injections
E. Referral to a specialist for further evaluation
Frozen shoulder (adhesive capsulitis) is a condition characterized by progressive pain and stiffness in the shoulder joint, leading to reduced range of motion. It typically occurs in middle-aged adults and is often self-limiting, with a longer course (6–12 months) and spontaneous resolution in many cases.
Physiotherapy is the first-line treatment for frozen shoulder, especially in the early stages. The goal is to reduce pain, maintain or improve range of motion, and prevent further stiffness. Initial interventions include:
Passive stretching and mobilization of the shoulder joint
Pain management (e.g., heat, ice, or gentle massage)
Patient education on the nature of the condition and the importance of continued movement
Gentle exercises to maintain mobility and prevent muscle atrophy
Surgical intervention is reserved for refractory cases (i.e., when conservative management has failed). Corticosteroid injections may be used in some cases, but they are not the first-line treatment. Shoulder braces are generally not recommended in the early stages, as they may worsen stiffness
