Rethinking Frozen Shoulder Management Through a Biopsychosocial Lens

Standard care is an injection followed by supervised physical therapy, with surgical options if that fails after three to six months. Injections into the rotator interval show better results in recent trials. Eric argues that the physical therapy in the supporting studies, such as hot packs, ultrasound and pendulum exercises, does not reflect contemporary practice. The part makes the case for seeing frozen shoulder as more than a shoulder problem. Chad Cook's Drivers of Pain and Disability model is used as an example, and frozen shoulder is linked to chronic systemic inflammation, diabetes, thyroid disease and metabolic syndrome, where reducing body fat and global exercise may help. Evidence for central sensitization is still limited. Motivational interviewing has been shown to increase self-efficacy and physical activity, and a systematic review found better adherence with a stronger therapeutic alliance in 56% of studies. Eric recommends using the Patient Specific Functional Scale, matching exercise to the patient's time and equipment, and planning around life events.