As noted in the Cochrane review by Page et al., laser therapy when added to exercise provided frozen shoulder patients with more pain relief than patients that received exercise therapy alone. 29 Ordahan et al. compared treating frozen shoulder with low level laser therapy versus treating with high power laser therapy. Shoulder pain was significantly improved in both groups demonstrating the effectiveness of laser therapy in helping to manage the symptoms of frozen shoulder. It is important to note, however, that the patients treated with high power laser therapy had better outcomes than those treated with low level laser therapy. 65 When it comes to improving shoulder function and range of motion, Pandy and Madi suggest a therapy program focused on mobilization of the shoulder including range of motion exercises as well as muscle strengthening exercises. 56 Jain and colleagues recommend adding heat therapy as it can help improve range of motion, shoulder function, and decrease pain. 59 Steroid injections and capsular distension are also common treatments for helping patients to regain function. However, a recent meta-analysis by Zhang and colleagues stated that “ESWT and laser therapy are the preferred new treatments” as both modalities have demonstrated benefits to patient recovery. 60 A clinical study by Naggar et al. demonstrated that treatment with radial shockwave therapy gave frozen shoulder patients more pain relief and better functional outcomes than those treated with an intra-articular steroid injection. 61 • In the Page et al. Cochrane review, patients treated with laser therapy and exercise had more functional improvement and better range of motion than those only completing exercises. 29 • The Ordahan et al clinical trial demonstrated that patients treated with laser therapy had significant functional improvement after three weeks. 65 Research supports this statement: •
In about 90% of patients, conservative treatment can provide patients pain relief and help them to regain their shoulder function. For those that need additional treatment, surgical procedures, such as glenohumeral manipulation or arthroscopic capsular release may be required. 56
Recommended modalities include
Electrical Stimulation 14
Shortwave Diathermy 14
Laser Therapy 29
Ultrasound 14
Stretching Exercises 14,29
RSW (Shockwave) 61
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