What would be the most appropriate approach for the first treatment of frozen shoulder?

The most appropriate approach for the first treatment of frozen shoulder, also referred to as adhesive capsulitis, is oscillations, specifically Grade 1 or 2 mobilizations. These gentle oscillatory movements are aimed at improving range of motion and relieving pain without causing further irritation to the shoulder joint.

In the initial stages of frozen shoulder, patients often experience significant stiffness and pain, making aggressive treatments inappropriate. Grade 1 and 2 oscillations are characterized by low-amplitude movements performed within the range of motion that does not provoke pain. They can help reduce muscle guarding and increase synovial fluid circulation around the joint, promoting healing. Additionally, this method can enhance mobility gradually and prepare the shoulder for more intensive rehabilitation as the condition progresses.

Heat therapy, while beneficial for muscle relaxation and increasing blood flow, may not directly address joint stiffness or the capsular restrictions central to frozen shoulder. Similarly, chiropractic adjustments are not typically focused on the range of motion or the specific soft tissue adaptations seen in frozen shoulder and might not target the underlying issues effectively. Ultrasound therapy, while it can be helpful in some circumstances, is generally not the first-line treatment for frozen shoulder. It may provide some pain relief but does not adequately address the mobility limitations that are essential