Participants

The patients were recruited from outpatients and inpatients of the orthopedics and traumatology department. Patients who were willing to participate in the research were evaluated to decide whether their condition met the study aim. In order to be eligible to participate in this study, patients must meet all of the inclusion criteria and none of the exclusion criteria.

Inclusion criteria were as follows: (1) subjects aged 40–70 years; (2) subjects clinically diagnosed with secondary FS characterized by restriction of function in the affected shoulder; (3) subjects that have definite cause, including trauma, non-osteoporotic fractures around the shoulder, long-term immobilization after lung cancer, breast cancer, or other surgery; (4) subjects that have the ability to comprehend the instructions in the study.

Exclusion criteria were as follows: (1) definitive evidence of rotator cuff tear, fracture, tumor in the shoulder, ligament rupture proved by magnetic resonance imaging (MRI); (2) allergy to narcotic drugs; (3) shoulder symptom resulting from skin contracture caused by cervical radiculopathy, brachial plexus lesion, connective tissue disorders, and scald around the shoulder; (4) other known shoulder pathology such as infection and broken skin; (5) pregnant, lactating women; (6) systemic inflammatory joint disease; (7) inability to give informed consent and fill out questionnaires; (8) unwilling to complete the medical observation.

From June 2019 to December 2020, a total of 136 eligible patients with a diagnosis of secondary FS were enrolled in the trial. The 136 patients were randomized to the MUA followed by EX group (n = 68) and celecoxib followed by EX group (n = 68) (Fig. 1).