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Abstract Idiopathic frozen shoulder is a condition of unknown origin where histological and histochemical studies support the idea of an underlying synovial inflammation with subsequent reactive capsular fibrosis. It is considered a benign condition lasting 18–30 months but high percentages of patients are left with some shoulder impairment. A correct diagnosis is the first and most important step: other pathologies need to be ruled out. Diagnostic criteria are: painful stiff shoulder for at least 4 weeks that interfered with daily living or work activity; painful restriction of both active and passive elevation to less than 100_ and 50% restriction of the external rotation; normal radiological appearance.The primary treatment should be based on physiotherapy and NSAID. Corticosteroid injections are only useful in the early stages to reduce disability and pain. Glenohumeral joint distension with saline solution alone or combined with steroids, provides short-term benefit. It remains to be determined whether joint distension with saline solution combined with corticosteroids provides more benefit than distension with saline alone or corticosteroids injection alone. The trend showed in literature; to repeat joint distensions in a short period of time needs further research to verify any clinical adjunctive benefit. Manipulation under anesthesia is sometimes used as a second step. It seems to be a safe procedure and should be considered as soon as possible, combined with an arthroscopic glenohumeral release if necessary.Arthroscopic gleno-humeral release has proven to be an effective procedure to treat frozen shoulder even if the post-operative pain can compromise the early results. |