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Question answered:02/08/06 Warning! this question is over two years old.
We found two review articles. However, neither discussed doing nothing.
The BMJ reviewed frozen shoulder in December 2005 [1]. With regard to treatments it makes the following summary points:
“Physiotherapy alone is of little benefit, although steroid injection is effective and best combined with physiotherapy
Refractory cases can be referred for manipulation under anaesthesia and, rarely, arthroscopic release
Nearly all patients recover, but normal range of movement may never return”
The review also discusses the natural history, reporting:
“Although the natural history of frozen shoulder is for ultimate resolution, this may not be complete. Reeves, in a prospective study of 41 patients with 5-10 years' follow-up, found that 39% had full recovery, 54% had clinical limitation without functional disability, and 7% had functional limitation. Shaffer et al showed that 50% of his 61 patients with frozen shoulder had some degree of pain and stiffness an average of seven years after onset of the disease.“
The review concludes:
“Frozen shoulder is a common, sometimes painful, but ultimately self limiting, condition that is usually managed in the primary care setting with a combination of analgesics, injections, and physiotherapy. Formal investigations are usually normal, and the diagnosis is essentially clinical. Most cases can be managed in the primary care setting. Educating patients plays an important part in the management of the condition. A minority of patients require referral to an orthopaedic specialist, where manipulation under anaesthesia is the most common method of treatment. Arthroscopic surgical release has proved itself to be useful in refractory cases. Irrespective of the treatment given, a high proportion of patients with frozen shoulder do not regain a full range of motion.”
For more information we recommend you read the full text (Athens password required).
In addition to the BMJ review eMedicine, an American online textbook, has a chapter on adhesive capsulitis [2]
With regard to the Niel-Asher technique we searched Medline, the Cochrane Library, the NLH musculoskeletal specialist library, Google scholar and the TRIP Database and found no trials.
References
1) Dias R et al. Clinical review: Frozen shoulder. BMJ 2005;331:1453-1456 (http://bmj.bmjjournals.com/cgi/content/extract/331/7530/1453)
2) eMedicine. Adhesive capsulitis. 2005 (http://www.emedicine.com/pmr/topic8.htm)
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