THE EFFECT OF MANIPULATION IN " FROZEN SHOULDER" TREATMENT

Since the prevalence of frozen shoulder disease is relatively high and efficacy of its treatment is obscure, this study was undertaken to evaluate the effect of manipulation in improving the range of motion, pain and daily activities. In this study that was conducted between 1996 and 2002, 30 patients(9male & 21 female) with mean age of 48 years (40-69) were under investigation. Patients were in the second stage of primary (idiopathic) frozen shoulder disease with the mean time of 9 months involvement and with 30% involvement in non dominant side of the body. After average of 7 sessions of physiotherapy the patients were treated with manipulation under anesthesia and intra articular steroid injection in shoulder in Shohadaye Haftom-e-Tir Education and Treatment Center. The patients were studied with using clinical trial (comparing before and after treatment) and with interview and examination. Then gathered information was analyzed through “matched t-test”. After average of 9 months of follow up, from range of motion point of view, 60 degree increase in forward elevation of upper limbs, 26 degree increase in external rotation of upper limbs and 2.5 vertebral level increase in internal rotation of upper limbs were observed. Pain in a 10 degree scale decreased from 7 to 1.5. Daily activities including wearing a coat, sleeping on the affected side and washing the back of body (while bathing) improved significantly. In no patient joint instability or recurrence in the same shoulder after manipulation or complications like fracture of humerus bone or rotator cuff tearing or dislocation occurred. The results were excellent or good in 29 patients. As a general conclusion it can be said that manipulation causes quick and noticeable improvement in movements, activities and pain and the patients become very much satisfied.