The Effect of Combined Manual Therapy and Curcumin Piperine Supplementation on Metabolic Factors, Inflammatory Markers, Oxidative Stress, Clinical Symptoms, and Electromyography in Patients with Frozen Shoulder: A Randomized, Placebo-Controlled Clinical Trial.

Inclusion criteria:

Agreement for participation in the study Age of 20 to 65 years old Diagnosis of frozen shoulder syndrome patients by an orthopedic specialist Duration of symptoms between 1 and 12 months

Exclusion criteria:

Unwillingness or inability to provide informed consent or adhere to the study protocol. Consumption of less than 80% of the prescribed supplement/placebo (verified by pill count). Voluntary withdrawal from the study or being lost to follow-up Occurrence of any allergic reaction or serious adverse event related to manual therapy or the supplement that makes continuation unsafe. Significant worsening of pain or functional limitation requiring additional intervention (e.g., corticosteroid injection or surgery) Systemic Inflammatory Diseases: Rheumatoid arthritis, ankylosing spondylitis, lupus, active gout, or other inflammatory arthropathies. Neuromuscular Disorders: Severe peripheral neuropathy, cervical radiculopathy, thoracic outlet syndrome, or stroke with residual upper limb impairment affecting function. Severe Uncontrolled Systemic Diseases: Renal or hepatic failure, active malignancy, bleeding disorders, active peptic ulcer disease, inflammatory bowel disease, cholelithiasis, or bile duct obstruction. Use of any supplement containing curcumin, turmeric, or other potent herbal anti-inflammatory agents within the past 4 weeks. Smoking Current participation in any other clinical trial. Other Shoulder Pathologies:* Diagnosis of impingement syndrome or full-thickness rotator cuff tear.* Symptomatic glenohumeral osteoarthritis.* Shoulder instability, prior dislocation, or history of surgery on the affected shoulder.* Cervical radiculopathy or other neurogenic causes of shoulder pain (confirmed by neurological examination).* Secondary frozen shoulder (due to diabetes, thyroid disorder, stroke, Parkinson's disease, trauma).

Target sample size: 60