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Frozen shoulder (FS) is an insidious, painful condition that results in a gradual restriction of movements. The
primary pathologic change in IAC is inflammation, and the fibrosis reaction is a secondary reaction, leading to
thickening, contracture, and adherence of the capsule and synovia as well as the surrounding ligamentous structures.
Many patients continue to have a significant long term painful restriction in their range of motion, although few are
functionally restricted. The normal course of FS has been described as having 4 stages: preadhesive, freezing, frozen,
and thawing. The diagnosis of FS is based on a thorough history taking and physical examination. Radiographs of
the shoulder are usually negative. Imaging studies including arthrography, ultrasonography, and magnetic resonance
imaging can be used to rule out concomitant conditions that may affect the treatment and to confirm FS. The goals
of treatment are to relieve pain, to restore restore func¬tion and motion of the shoulder, and improve quality of
life. Treatments for FS range from con¬servative treatments including physical therapy, thera¬peutic exercise, joint
mobilization and manipulation, nonsteroidal anti-inflammatory and opioid medications, intra-articular steroid and
hyaluronic acid injections, suprascapular nerve block, glenohumeral distention ar¬thrography with and without
steroid supplementation, and manipulation under general anesthesia to surgical intervention. Clinically effective
joint mobilization and manipulation improves tissue extensibility, reduces soft tissue swelling and inflammation,
reduces pain, increases range of mo¬tion, and stimulates peripheral mechanorecep¬tors in FS. It is necessary to
refine the selection of treatment for individual patients according to the phase of the disease.
Gi-Young Park graduated and got degree of MD, phd from Yonsei University College of Medicine (Seoul, Korea). He has been a head professor of Department of Rehabilitation Medicine in Daegu Catholic University Hospital since 2008. He published more than 100 papers in reputed journals and elected as the next president of Korean Academy of Neuromusculoskeletal Sonography. He have been teaching rehabilitation medicine and neuromusculoskeletal ultrasound since 1995 and has given many lectures and hands on instructions at courses organized by universities, academies, and societies in Korea, Taiwan, China, Japan, India, and Myanmar etc.