Interventions for adhesive capsulitis: systematic review and network meta-analysis of randomised controlled trials.

Extracorporeal shockwave therapy probably reduces short-term pain in adults with adhesive capsulitis versus usual care, with a mean difference of -1.97 on a 0–10 scale.

• Why it matters: Pain and functional limitation are central outcomes in adhesive capsulitis, but comparative benefits and harms across many interventions remain unclear, especially beyond short-term effects.
• What they did: A systematic review and network meta-analysis of 189 randomized controlled trials (12 988 participants) compared 59 interventions, assessing pain, function, range of motion, and adverse events.
• The result: Manipulation under anaesthesia, with or without intra-articular steroid injections, probably improves short-term flexion (33.29° and 26.16°), while safety and most mid-term effects remain highly uncertain due to incomplete reporting and incoherence.

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