Physical Therapy and Manipulation under Anesthesia for Patients with a Frozen Shoulder

Document Type : Narrative Review


1 Departement of Orthopaedic and Traumatology, Medical Faculty, Udayana University-Sanglah General Hospital Denpasar, Indonesia

2 Faculty of Medicine, Udayana University, Bali, Indonesia


Frozen  Shoulder  (FS)  has  been  a  common  disease  that  causes  notable  morbidity. Conservative treatments starting from oral medication, physical therapy, exercise,  steroid  injection,  and  hydrodilatation can be  chosen before surgical procedure. Recently, there are many arguments regarding the Manipulation Under Anesthesia (MUA) procedure whether it is good or bad compared to physical therapy. This study was carried out by reviewing and searching journals with the keywor ds “bursitis”, “frozen  shoulder”, “physical  therapy”, “manipulation  under  anesthesia”, and “conservative” on the search engines. From 47 journals that were  reviewed,  45 were found composed as references  for this review.  There is no exact consensus from few pieces of literature to define which FS patients will benefit the most following the MUA procedure. Physical therapy or home exercise is still the first-line treatment for FS. Most of the cases showed that this first line of treatment is capable of resolv ing FS. Physical therapy has its place in every phase of the FS, starting from the freezing until the thawing phase. It seems that physical therapy is still the most important treatment to be applied as most of the studies reported satisfaction alongside the combination of other conservative treatments.