Watchful waiting may decrease health care costs vs. physical therapy for frozen shoulder
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Key takeaways:
- Watchful waiting yielded similar patient-reported outcomes vs. physical therapy for adhesive capsulitis.
- However, health care costs of physical therapy were 10 times greater compared with watchful waiting.
SAN FRANCISCO — For patients with idiopathic adhesive capsulitis or “frozen shoulder,” watchful waiting yielded similar outcomes with lower costs and decreased health care burden vs. physical therapy, according to presented results.
At the American Academy of Orthopaedic Surgeons Annual Meeting, Scott D. Martin, MD, FAAOS, presented results from a single-provider randomized controlled trial of 61 patients who sought treatment for idiopathic adhesive capsulitis between November 2014 and November 2022. Among the cohort, 31 patients (51.8%) were randomly assigned to watchful waiting, while 30 patients (49.2%) were randomly assigned to physical therapy.
“Physicians should inform their patients with adhesive capsulitis of the treatment options,” Martin told Healio. “These include nonoperative management with medications, physical therapy, watchful waiting and surgery when indicated, all of which have similar success rates.”
Martin and colleagues analyzed the value of both treatment options by comparing American Shoulder and Elbow Surgeons scores with total health care costs. They also analyzed DASH scores and VAS pain scores.
Researchers found both the watchful waiting and physical therapy cohorts had improved patient-reported outcomes at 1 year with no significant differences in improvement trajectories between the cohorts. However, Martin noted the health care costs of the physical therapy cohort were 10 times greater compared with the watchful waiting cohort. Martin also noted physical therapy imposed a greater economic burden upon the health care system compared with watchful waiting.
“With existing health care disparities, which include underserved minorities, we can counsel and assure patients that watchful waiting is a safe option for the treatment of frozen shoulder with similar outcomes vs. physical therapy over time,” Martin concluded.
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Martin SD, et al. Paper 401. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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