I agree with Dr. Lollino to some extent. However, "frozen shoulder" is still a poorly defined syndrome. There is a variety of cases as far as etiology, pathological changes, longevity of complaints, grade of restricted ROM,etc. are concerned. So I believe the good diagnosis making is very important. And then the therapeutical approach. Arthroscopic release is gaining on popularity. Anyway, I still believe some cases may benefit from manipulation under anesthesia as an adjunct procedure to physiotherapy.

The blocked of the supraescapular nerve is a secure and effective procedure for adhesive capsulitis with pain control,gain range of motion and maximum arc movement

Dear Nelson, I do not understand your last answer. Would you be so kind to explain this procedure and how it works ?

Dear Panayot

The technique of blocking supraescapular nerve consists of injecting anesthetic into the supraspinatus fossa of the affected shoulder. The site of the needle insertion is lateral vertex obtained from two imaginary lines draw on the posterior border of the clavicle and the anterior edge of the scapular spine, lateral to the coracoid process and its used bupivacaine 0,5% with epinephrine bitartarate 1:200 000 (Marcaine ) without the combination of a corticosteroid (15/15 days)

Thank you, Nelson. I find some reason for suprascapularis nerve blockade when neurotropic changes affect the articular capsule of the shoulder joint. In the case of "frozen shoulder" it may be beneficial when the adhesive changes engage the upper and posterior part of the capsule (zone of innervation from n.suprascapularis). However, the imaging and ultrasound diagnostics in adhesive capsulitis of the shoulder very often show changes in the coracohumeral ligament and around the tendon of the biceps brachii long head which are located anteriorly. The clinical presentation (restricted abduction) also suggests progressive changes in the inferior portion of the capsule. So, probably, this block works in selected cases, but not in all.

It seems to be important to pay attention to the stage of the inflammatory/structural changes.

Unfortunatly there is not much evidende about the subject.

Some good resources to look into from evidence-based practice guidelines to modalities:

https://www.researchgate.net/publication/273778415_Frozen_shoulder_A_systematic_review_of_therapeutic_options

https://www.researchgate.net/publication/265055471_Manual_therapy_and_exercise_for_adhesive_capsulitis_%28frozen_shoulder%29

https://www.researchgate.net/publication/236602605_Shoulder_pain_and_mobility_deficits_adhesive_capsulitis

https://www.researchgate.net/publication/221691528_Management_of_frozen_shoulder_a_systematic_review_and_cost-effectiveness_analysis

Good luck!

Article Frozen shoulder: A systematic review of therapeutic options

Article Manual therapy and exercise for adhesive capsulitis (frozen shoulder)

Article Shoulder Pain and Mobility Deficits: Adhesive Capsulitis

Article Management of frozen shoulder: A systematic review and cost-...

Physiotherapy

Very nice resource is the following article! I believe PT + Pain education combination works well in most of the cases! 

Article Shoulder Pain and Mobility Deficits: Adhesive Capsulitis