Adhesive capsulitis, or “frozen shoulder,” is a painful shoulder condition that progresses through three phases: freezing, frozen, and thawing. There is no established gold standard treatment for this condition; however, the primary goals of treatment are to alleviate pain and restore shoulder mobility. This study aimed to evaluate the effectiveness of ultrasound-assisted glenohumeral hydrodistension combined with physical therapy in managing adhesive capsulitis. Specifically, it compared outcomes in terms of pain relief and range of motion between patients in phase 1 and phase 2 of the disease. Between January 2022 and April 2023, 87 patients with adhesive capsulitis were evaluated, 47 of whom were excluded due to other concurrent conditions, leaving 40 patients for the study. Of these, 23 patients were in phase 1, while 17 were in phase 2. Patients were assessed at the start and then at 2, 4, and 6 months after receiving hydrodistension treatments. The range of motion in all planes, pain levels, and functionality scores were recorded at each follow-up.
Results showed a marked improvement in shoulder range of motion in all planes except extension across both groups. Phase 2 patients regained range of motion in all directions except internal rotation, which proved more challenging to recover. Pain and functionality scores showed substantial improvement from baseline to follow-up visits for both groups. The findings underscore that ultrasound-guided hydrodistension of the glenohumeral joint, when combined with targeted exercises, is effective in reducing pain, improving shoulder function, and enhancing range of motion in patients with early and mid-stage adhesive capsulitis. Importantly, early diagnosis before complete range of motion loss in phase 2 can maximize treatment benefits.
