Hydroplasty with Manipulation Offers Faster Mid-Term Recovery in Frozen Shoulder, Study Finds
Randomized study shows combining hydroplasty and shoulder manipulation with steroid injection improves recovery more quickly than steroid injection alone, though both treatments deliver similar results after six months.
A new clinical study suggests that patients with frozen shoulder may achieve faster functional recovery when intra-articular steroid injection is combined with hydroplasty and shoulder manipulation rather than receiving a steroid injection alone. Researchers found that while both treatment approaches significantly reduced pain and disability, the combined procedure provided superior improvement during the mid-term recovery period.
The study compared two treatment strategies for adhesive capsulitis, commonly known as frozen shoulder. One group received a standard intra-articular corticosteroid injection, while the second group underwent corticosteroid injection combined with hydroplasty—a procedure that stretches the shoulder capsule by injecting fluid—and gentle manipulation to improve joint mobility. Researchers monitored patients for six months using the Shoulder Pain and Disability Index (SPADI).
Both groups experienced steady reductions in pain and significant improvements in shoulder function throughout the follow-up period. During the first six weeks, outcomes were nearly identical, indicating that both therapies were effective in providing early symptom relief.
However, patients receiving the combined treatment demonstrated significantly better functional recovery at three months and again at 4.5 months. Their SPADI scores improved more rapidly, suggesting that hydroplasty with manipulation accelerates restoration of shoulder mobility and daily function during the intermediate phase of recovery.
By the six-month follow-up, the difference between the two groups had disappeared. Researchers found no statistically significant variation in pain or disability scores at the end of the study, indicating that both treatment methods ultimately produced comparable long-term outcomes. Importantly, no major complications were reported in either treatment group.
Frozen shoulder is characterized by progressive pain, stiffness and restricted movement of the shoulder joint. It commonly affects adults between 40 and 65 years of age and is particularly prevalent among people with diabetes and thyroid disorders. Without treatment, recovery may take months or even years.
The researchers concluded that hydroplasty combined with manipulation may be particularly beneficial for patients seeking quicker functional recovery, while a steroid injection alone remains an effective and less complex treatment option. They emphasized that treatment decisions should be individualized based on symptom severity, patient preference and clinical assessment. Larger studies are needed to confirm whether the combined approach should become a preferred standard for managing frozen shoulder.
