Cold therapy for adhesive capsulitis of the shoulder
Evidence review
Overview
One randomized trial in 30 patients with adhesive capsulitis found that adding whole-body cryotherapy (WBC) to physical therapy and shoulder mobilization produced greater improvements in pain, range of motion and shoulder function than physical therapy and mobilization alone. WBC is a short exposure to extreme cold air in a chamber, a different method from a home cold plunge. The trial is small and has not been replicated.
Key findings
- RCT, n=30: greater improvement with WBC added in pain VAS, active flexion, abduction, internal and external rotation and ASES score (all p<0.01) (Ma 2013).
- No cold-water immersion or cold plunge study in adhesive capsulitis identified.
Every study we reviewed
1 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 26 studies on chronic pain and musculoskeletal conditions, across all heat and cold therapies, including case reports and older work not graded here.
Effects of whole-body cryotherapy in the management of adhesive capsulitis of the shoulder.
Ma SY et al. Arch Phys Med Rehabil. 2013. PubMed 22850489 · DOI
- Who
- Hospital patients with adhesive capsulitis of the shoulder (Korea)
- What
- WHOLE-BODY CRYOTHERAPY added to physical therapy modalities and passive shoulder mobilization vs the same therapy without WBC
- Measured
- Pain VAS, active shoulder range of motion, ASES score
- Result
- Greater improvements with WBC in VAS, active flexion, abduction, internal and external rotation and ASES (all between-group p<0.01); both groups improved
- Limitations
- Single small trial; no blinding described; short-term; WBC, not cold-water immersion
Protocols used in the studies
Whole-body cryotherapy added to physical therapy modalities and passive joint mobilization; chamber temperature and schedule are not reported in the abstract.
What is still unknown
Replication in larger, blinded trials; durability; whether local cooling or cold-water immersion gives similar results.
Safety
Cautions for cold therapy in this condition
- Whole-body cryotherapy contraindications and adverse events (16 documented across case reports and RCTs) are specific to cold-air chambers and do not transfer directly to cold-water immersion (Legrand 2023, PMID 37770960). See general cold safety entry.
For clinicians
Suggested rationale
A small randomized trial found that whole-body cryotherapy added to physical therapy improved pain and shoulder range of motion in adhesive capsulitis (Ma 2013); the evidence concerns a cold-air chamber and does not establish benefit for cold-water immersion.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: M75.00, M75.01, M75.02. Examples only; the clinician assigns the code.
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