Short-term outcomes of adding supervised joint mobilization to ultrasound-guided suprascapular nerve block plus home exercise for frozen shoulder: a single-center retrospective cohort study

Objective To compare 4-week short-term outcomes associated with adding supervised joint mobilization to ultrasound-guided suprascapular nerve block (SSNB) plus home exercise in patients with frozen shoulder and to explore factors associated with poor treatment response. Methods This single-center retrospective cohort study included 124 patients with frozen shoulder who received SSNB between January 2024 and December 2024. The basic-treatment group received SSNB plus home exercise ( n = 58), and the combined-treatment group received the same basic treatment plus supervised joint mobilization ( n = 66). VAS pain score, shoulder range of motion, Constant-Murley Score (CMS), Shoulder Pain and Disability Index (SPADI), clinical response, and adverse events were evaluated at baseline and/or at 4 weeks. Continuous 4-week outcomes were analyzed by ANCOVA with adjustment for the corresponding baseline value and age; poor response was additionally analyzed by logistic regression adjusted for age and baseline VAS. Results After adjustment for the corresponding baseline value and age, compared with the basic-treatment group, the combined-treatment group had a lower VAS score [adjusted mean difference (AMD), −0.78; 95% CI, −1.37 to −0.19; P = 0.010], greater forward flexion, abduction, and external rotation (AMD, 4.78°, 4.03°, and 3.38°, respectively; all P < 0.05), and a lower SPADI total score (AMD, −6.80; 95% CI, −11.08 to −2.53; P = 0.002). The adjusted between-group difference in CMS total score was not statistically significant (AMD, 3.42; 95% CI, −0.50 to 7.35; P = 0.087). The overall response rate was 89.39% in the combined-treatment group and 70.69% in the basic-treatment group; after adjustment for age and baseline VAS, combined treatment was associated with lower odds of poor response (adjusted OR, 0.319; 95% CI, 0.117–0.868; P = 0.025). Adverse-event rates did not differ significantly between groups ( P = 0.147). Conclusion In this single-center retrospective cohort, adding supervised joint mobilization to SSNB plus home exercise was associated with better 4-week pain, range-of-motion, and SPADI outcomes after adjustment for age and corresponding baseline values; the adjusted CMS difference was not statistically significant. These findings represent short-term associations and do not establish causality or long-term benefit.