An Experimental Study on the Clinical Burden of Frozen Shoulder Syndrome and the Role of Thoracic Spine Manipulation in Physiotherapy Management

Background: Frozen shoulder syndrome is a major clinical burden in physiotherapy practice anddisproportionately affects the working-age population and can cause prolonged pain, disability and poorquality of life. Physiotherapy management is usually based on exercise, but the extent to which adjunctivethoracic spine physiotherapy manipulation reduces this burden within a standard management pathway isunderexplored. Objective: To determine the clinical and demographic presentation of frozen shouldersyndrome in a physiotherapy OPD population and to evaluate the role thoracic spine manipulation alongwith exercise in reducing the burden of frozen shoulder Methods: A total of 60 patients with adhesivecapsulitis were evaluated by demographic distribution (age, gender, side involved) and randomised intotwo groups: Group A (thoracic spine manipulation plus exercises, n=30) Group B (exercises only, n=30),with functional burden measured using the DASH questionnaire throughout the treatment period. Results:The age range with the highest burden of frozen shoulder in this population was 41–60 years (93.3% GroupA, 86.7% Group B), and two-thirds of patients were female and right side involvement. Group A showed agreater and earlier reduction in DASH score (mean difference – 40.50 point ) from baseline to 6th weekthan reported with exercise alone. Conclusion: Frozen shoulder syndrome has a significant burden in theworking-age population. Physiotherapy management incorporating thoracic spine manipulation reduce thisburden much greater extent and more quickly than exercise alone, making it an integral part of standardmanagement.