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Frozen shoulder guidelines
Cumulative incidence of frozen shoulder (adhesive capsulitis) is estimated at 2.4 per 1000 population per year (BESS/BOA guidelines).
This is a condition which in many cases appears to be idiopathic; it is known to be associated with diabetes in 30% of cases. It is divided into two broad phases which overlap: pain predominant and stiffness predominant. Appropriate intervention will vary depending on the stage at which presentation occurs. That being the case it is important that a clear understanding, not only of the diagnosis, but also of the stage, can be reached by the clinician.
Community based treatments including analgesia, landmark guided injection and physiotherapy are the mainstay of treatment for most shoulder conditions
Adults in primary care with frozen shoulder
Patients without frozen shoulder
AP and lateral plain radiographs to exclude (in the main) osteoarthritis may be considered
The following strategies/interventions are suitable for employment in primary care (by either GP or physiotherapist):
In a patient who is either severely disabled by pain and stiffness (severe night pain unrelieved by analgesia and inability to work or undertake activities of daily living without help), onward referral can be considered.
This guideline has been signed off by South Devon and Torbay CCG.
Publication date: December 2017