Primary Frozen Shoulder: Diagnosis, Staging and Non-Surgical Care — A Clinical Practice Guideline and a Rehabilitation Meta-Analysis

Physical therapists, physical therapist assistants and certified hand therapists who evaluate or treat adults with painful, stiff shoulders and want a plain-language account of what current guideline and meta-analytic evidence reports about diagnosis and non-surgical management of primary frozen shoulder.

Physical therapists, physical therapist assistants working under the direction and supervision of a physical therapist, and certified hand therapists in outpatient orthopedic, hand therapy and general rehabilitation settings.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of two published papers and adds no claims beyond them.

Lee BC, Kim BS, Lee BJ, Moon CW, Park CH, Kim DH, Yun DH, Park D, Kim DY, Kim DH, Kim GW, Kim HJ, Jung IY, Kim IJ, Park JH, Lee JH, Ahn J, Lim JY, Yoon JA, Lee JH, Hwang JM, Kim K, Uhm KE, Choi KH, Nam KE, Min K, Chang MC, Park MW, Kim N, Park HK, Kim SH, Yang S, Won SJ, Moon SG, Chung SJ, Jee S, Lee WH, Park YB, Na Y, Won YH, Im YJ, Yoon YS, Lee YJ, Soh Y, Han JY. Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder. Ann Rehabil Med. 2025;49(3):113-138. doi:10.5535/arm.250057

Hamed-Hamed D, Pérez Montilla JJ, Brindisino F, Struyf F, Navarro-Ledesma S. Rehabilitation of Frozen Shoulder: A Systematic Review and Meta-Analysis of Multifactorial Interventions. Pain Res Manag. 2026;2026(1):e3820129. doi:10.1155/prm/3820129

A note on scope

Both papers report on injections, hydrodilatation and medication. Those findings are reported here as the papers reported them, attributed to the paper that reported them, and are not offered as physical therapy interventions.

After completing this course, you will be able to:

1. Describe how the clinical practice guideline reported that primary frozen shoulder is diagnosed and what role it assigned to ultrasound and magnetic resonance imaging.
2. State which non-surgical interventions the clinical practice guideline graded as conditionally recommended and which it labeled inconclusive, and what those grades mean.
3. Explain what the systematic review and meta-analysis reported about exercise-based rehabilitation for pain, function and range of motion, and how certain its authors were in that finding.

1. Start Here: Course Overview, Objectives and How Credit Is Earned
2. Part One: The Clinical Practice Guideline on Primary Frozen Shoulder
3. Primary Frozen Shoulder: Who the Guideline Addresses
4. Building the Guideline: Searches, Risk of Bias and GRADE
5. Diagnosis, Staging and the Place of Ultrasound and MRI
6. Non-Surgical Treatment Recommendations and the Grades Attached to Them
7. Part Two: The Systematic Review and Meta-Analysis of Rehabilitation Interventions
8. The Frozen Shoulder Population Behind the Review
9. How the Review Searched, Appraised and Pooled the Evidence
10. What Exercise-Based Rehabilitation Produced for Pain, Function and Motion
11. Metabolic and Psychological Correlates, and the Certainty Ceiling
12. Bringing It Together
13. Where the Guideline and the Review Point the Same Way
14. Where the Two Papers Diverge, and Which One Found What
15. What a Physical Therapy Plan of Care Can Draw From Both
16. What the Two Papers Leave Unanswered
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Lee BC, Kim BS, Lee BJ, Moon CW, Park CH, Kim DH, Yun DH, Park D, Kim DY, Kim DH, Kim GW, Kim HJ, Jung IY, Kim IJ, Park JH, Lee JH, Ahn J, Lim JY, Yoon JA, Lee JH, Hwang JM, Kim K, Uhm KE, Choi KH, Nam KE, Min K, Chang MC, Park MW, Kim N, Park HK, Kim SH, Yang S, Won SJ, Moon SG, Chung SJ, Jee S, Lee WH, Park YB, Na Y, Won YH, Im YJ, Yoon YS, Lee YJ, Soh Y, Han JY. Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder. Ann Rehabil Med. 2025;49(3):113-138. doi:10.5535/arm.250057
2. Hamed-Hamed D, Pérez Montilla JJ, Brindisino F, Struyf F, Navarro-Ledesma S. Rehabilitation of Frozen Shoulder: A Systematic Review and Meta-Analysis of Multifactorial Interventions. Pain Res Manag. 2026;2026(1):e3820129. doi:10.1155/prm/3820129