Effectiveness of Focal Extracorporeal Shockwave Therapy for Idiopathic Frozen Shoulder at 12‐Month Follow‐Up

The optimal treatment for frozen shoulder remains a subject of debate, within the orthopedic and rehabilitative communities, primarily due to the complexity of the pathology and the lack of consensus on therapeutic protocols, which range from conservative physical therapy to invasive surgical intervention. In this clinical landscape, noninvasive modalities have gained considerable traction for their potential to accelerate functional recovery and alleviate debilitating pain. The aim of this study was to evaluate the 12‐month long‐term results of focal extracorporeal shockwave therapy (f‐ESWT) in the treatment of idiopathic frozen shoulder. We prospectively collected data from 77 patients (42 females, 35 males; mean age: 57 years) suffering from idiopathic frozen shoulder between January 2021 and September 2022. The median number of f‐ESWT sessions performed was 6 (range: 2–10). Forty‐three patients received f‐ESWT treatment within 3 months of symptom onset. Patients were assessed at baseline, at the end of treatment, and at 2‐, 6‐, and 12‐month follow‐up intervals using the Constant–Murley Score (CMS), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Visual Analog Scale (VAS). A statistically significant improvement of CMS and reduction of DASH and VAS were observed from the baseline values to posttreatment evaluations ( p < 0.001). Serial measurements revealed a bimodal trend of clinical improvements: a significant statistical difference from baseline values to both the end of the treatment and at the 2‐month follow‐up, followed by a clinical plateau up to a final, statistically significant improvement at the 12‐month follow‐up. Patients who initiated f‐ESWT within 3 months of symptom onset, as well as those who underwent fewer than seven sessions, exhibited significantly lower DASH values at the 2‐month follow‐up ( p = 0.013). In conclusion, satisfactory clinical outcomes of f‐ESWT for idiopathic frozen shoulder can be expected at 12 months, particularly for patients starting treatment early (within 3 months of onset) and receiving fewer than seven sessions.