Nonpharmacological management for adhesive capsulitis

Discuss the natural history of adhesive capsulitis with the person, including their concerns, goals and expectations, and a proposed management plan including self-management and simple advice on activity modification. Emphasise that adhesive capsulitis can have a prolonged course associated with considerable disability; however, encourage maintenance of general physical fitness.

During the initial painful phase of adhesive capsulitis, advise people to avoid or modify activities that aggravate shoulder discomfort. Avoid manual therapies and high-load shoulder exercises because they can intensify pain. Advise the person that the initial painful phase is generally the worst and may last 6 to 12 months.

During the intermediate stiff (frozen) and recovery phases, continue activity modification to prevent pain. A reasonable exercise recommendation is to work towards strengthening the shoulder, and to perform active range-of-motion exercises. The aim is to gradually increase range of motion of the shoulder without aggravating symptoms.