Manifestation & Determinants of Frozen Shoulder in Patients with Diabetes: A cross-sectional study

Abstract

Background: Frozen Shoulder (FS), or adhesive capsulitis, is a common musculoskeletal complication among individuals with diabetes mellitus, characterized by pain and progressive restriction of shoulder joint mobility. Despite its high prevalence, especially in diabetic populations, region-specific data on its determinants and manifestations remain scarce, particularly in Bangladesh. Objective: This study aimed to investigate the manifestation and determinants of frozen shoulder in diabetic patients attending a tertiary care center in Bangladesh. Methods: A cross-sectional study was conducted among 96 diabetic patients at CRP, Savar, Dhaka. Data were collected through face-to-face interviews using a semi-structured questionnaire and the Shoulder Pain and Disability Index (SPADI). Chi-square tests were applied to assess associations between frozen shoulder and potential risk factors. Results: The prevalence of frozen shoulder in the diabetic population was 41.3%. A statistically significant association was found between frozen shoulder and the following variables: sex (p=0.027), duration of diabetes (p=0.037), type of diabetic treatment (p=0.010), regular physical activity (p=0.007), family history of shoulder disorders (p=0.010), and past shoulder injury (p=0.017). However, age (p=0.542) and cardiovascular disease (p=0.437) did not show significant associations. The mean SPADI pain and disability scores were 48.33% and 44.03%, respectively, indicating moderate functional impairment. Conclusion: Frozen shoulder is highly prevalent among diabetic patients and is influenced by several modifiable and non-modifiable factors. Early screening, regular exercise, and proper glycemic control could help mitigate the risk. These findings highlight the need to incorporate musculoskeletal assessments into routine diabetes management in Bangladesh. Keywords: Frozen shoulder, adhesive capsulitis, diabetes mellitus, SPADI, musculoskeletal disorder, Bangladesh, physiotherapy, risk factors, cross-sectional study