Table 1

Evidence for effectiveness of interventions for frozen shoulder

Placebo-controlled trials
 OMOral steroids vs placebo/no treatment3 weeks ± 7 weeks NDNDND
 IAJSteroid injections vs placebo/no treatment+++++
 PTLaser vs placebo+++
 OTElectroacupuncture vs placebo+
Interferential acupuncture vs placebo+
Arthrographic distension vs placebo3 weeks ++
SSNB vs placebo1 month ++
Head-to-head comparisons
 OMOral steroids vs steroid injection1 week +
Oral steroids vs before manipulation vs manipulation alone++
 IAJSteroid injections vs physiotherapy±±±
Steroid injections vs arthrographic distension±±
Steroid injections vs manipulation under anaesthesiaND
 PTMobilisation and exercise vs exercise alone4 weeks ++
High-grade mobilisation vs low-grade++
Posterior glide joint mobilisation vs anterior glide joint mobilisation3 weeks ++
End-range mobilisation vs mid-range mobilisation++
Mobilisation with movement vs midrange mobilisation++
Cyriax method vs hot pack and short wave application2 weeks ++
Ibuprofen alone vs ibuprofen and physiotherapy3 weeks +
OTAcupuncture and exercise vs exercises alone++
Acupuncture vs suprascapular nerve block30 min +
Traditional acupuncture vs Jing Luo+
Electroacupuncture vs interferential acupuncture4 weeks ND
SSNB vs steroid injections++
Needle tip guided by superficial bony landmarks vs near-nerve electromyographically guided60 min ND
Arthrographic distension and physiotherapy vs physiotherapy alone+
Arthrographic distension and active physiotherapy vs arthrographic distension and passive physiotherapy++
Arthrographic distension and passive physiotherapy and TENS vs arthrographic distension aloneDirect postoperative +
Manipulation under anaesthesia and exercises vs exercises alone++
  • ‘In favour of’ is indicated in bold.

  • +, limited evidence found; ++, moderate evidence found; +++, strong evidence found; ±, conflicting evidence for effectiveness.

  • IAJ, intra-articular steroid injection; LT, long term; MT, mid term; ND, no differences found: randomised clinical trials available, but no differences found for effectiveness of the treatment between intervention and control groups; OM, oral medication; OT, other treatment; PT, physiotherapy; SSNB, supra scapular nerve block; ST, short term.