AN EXPERIMENTAL STUDY ON THE CLINICAL BURDEN OF FROZEN SHOULDER SYNDROME AND THE ROLE OF THORACIC SPINE MANIPULATION IN PHYSIOTHERAPY MANAGEMENT

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Background: Frozen shoulder syndrome is a major clinical burden in physiotherapy practice and
disproportionately affects the working-age population and can cause prolonged pain, disability and poor
quality of life. Physiotherapy management is usually based on exercise, but the extent to which adjunctive
thoracic spine physiotherapy manipulation reduces this burden within a standard management pathway is
underexplored. Objective: To determine the clinical and demographic presentation of frozen shoulder
syndrome in a physiotherapy OPD population and to evaluate the role thoracic spine manipulation along
with exercise in reducing the burden of frozen shoulder Methods: A total of 60 patients with adhesive
capsulitis were evaluated by demographic distribution (age, gender, side involved) and randomised into
two 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% Group
A, 86.7% Group B), and two-thirds of patients were female and right side involvement. Group A showed a
greater and earlier reduction in DASH score (mean difference – 40.50 point ) from baseline to 6th week
than reported with exercise alone. Conclusion: Frozen shoulder syndrome has a significant burden in the
working-age population. Physiotherapy management incorporating thoracic spine manipulation reduce this
burden much greater extent and more quickly than exercise alone, making it an integral part of standard
management.