Functional Outcome of Frozen Shoulder in Diabetics Versus Nondiabetics Treated with Physical Therapy

Background: Frozen shoulder affects 3% of the general population, with diabetic patients having 3–4 times higher risk. While physical therapy represents first-line conservative treatment, existing literature provides conflicting evidence regarding comparative treatment outcomes between diabetic and nondiabetic patients. Through this study, we evaluated and compared the pain score and functional outcome in diabetic and nondiabetic patients treated with a standardized physical therapy protocol. Subjects and Methods: The study was an interventional comparative study. Patients presenting to the outpatient department of a tertiary care hospital diagnosed with frozen shoulder were included in the study. The patients were divided into two groups: diabetic and nondiabetic. All participants underwent a standardized physical therapy program. The functional outcomes and pain were assessed using the Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS) scores at baseline, 1 month, 3 months, and 6 months. The effect of body mass index and prior steroid use on clinical outcomes was also analyzed. Results: The study included 45 participants, with 31 (68.89%) diabetic patients, 12 (26.67%) nondiabetic patients, and 2 (4.44%) prediabetic patients. The mean SPADI pain and disability before intervention was 50.52 and 45.40 in diabetics and 58.67 and 49.48, respectively, in nondiabetics. These scores improved to 16.21 and 15.74 in diabetics and 22 and 15.06 in nondiabetics, respectively. The pain score improvement was also similar. Conclusion: Both diabetic and nondiabetic patients with primary frozen shoulder experienced clinically meaningful reductions in pain (mean VAS reduction ≥4 points) and SPADI scores (mean improvement ≥ 30 points) following six months of standardized physical therapy, with no significant difference between the two groups.