Watchful Waiting Shows Value as Treatment Option for Frozen Shoulder

SAN FRANCISCO, Feb. 12, 2024 /PRNewswire/ — Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder, resulting in difficulty of movement in the shoulder. It affects 2-5% of the population, typically those between 40 and 60 years of age. People with diabetes and hypothyroidism are at an increased risk. Even without treatment, frozen shoulder can get better with time; however, recovery may take up to three years. Pain medications and physical therapy (PT) are typically used as the main treatments, but there is little evidence supporting the use of PT.

Study Comparing Frozen Shoulder TreatmentsA single-provider, randomized controlled trial (RCT) study presented at the 2024 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) used patient-reported outcome measures (PROMs) and health care costs to compare watchful waiting (WW) versus PT for the treatment and management of frozen shoulder. The study, “Watchful Waiting Achieves Higher Value Than Physical Therapy for the Treatment of Idiopathic Frozen Shoulder: A Prospective Randomized Controlled Trial,” randomized 61 patients to either WW (31 patients) or PT (30 patients) and assessed outcomes at six weeks, three months, six months and 12 months.

This is the first RCT to compare PT versus WW for frozen shoulder treatment using a value-based health care framework. The primary outcome was the American Shoulder and Elbow Surgeons Score (ASES), and secondary outcomes included the patient value (12-month ASES score divided by health care costs). The outcomes of the study include:

WW and PT patients improved significantly at each time point for all PROMs (p0.05 for all).
PT patients incurred 10 times higher costs than WW patients (normalized mean difference: 1,635.67; 95% CI: 967.19, 2,304.15; p