Treatment of Adhesive Capsulitis of the Shoulder.
@article{Redler2019TreatmentOA, title={Treatment of Adhesive Capsulitis of the Shoulder.}, author={Lauren H. Redler and Elizabeth R. Dennis}, journal={The Journal of the American Academy of Orthopaedic Surgeons}, year={2019}, volume={27 12}, pages={ e544-e554 } }
Adhesive capsulitis presents clinically as limited, active and passive range of motion caused by the formation of adhesions of the glenohumeral joint capsule. Radiographically, it is thickening of the capsule and rotator interval. The pathology of the disease, and its classification, relates to inflammation and formation of extensive scar tissue. Risk factors include diabetes, hyperthyroidism, and previous cervical spine surgery. Nonsurgical management includes physical therapy, corticosteroid…
45 Citations
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Management is based on the underlying cause of pain and stiffness, and determination of the etiology is essential, and Diligent postoperative therapy to maintain motion is required to minimize recurrence of adhesive capsulitis.
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Different imaging modalities including arthrography, ultrasound, magnetic resonance, and magnetic resonance arthography may help to confirm the diagnosis of adhesive capsulitis, detecting a number of findings such as capsular and coracohumeral ligament thickening, poor capsular distension, extracapsular contrast leakage, and synovial hypertrophy and scar tissue formation at the rotator interval.
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Patients with idiopathic adhesive capsulitis treated with an arthroscopic capsular release had early significant improvements in shoulder range of motion, pain frequency and severity, and function, and these improvements were maintained and/or enhanced at seven years.
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This intention to treat RCT in primary care indicates that four injections with corticosteroid with or without distension, given with increasing intervals during 8 weeks, were better than treatment-as-usual in treatment of adhesive shoulder capsulitis, however, in the long run no difference was found between any of the groups, indicating that natural healing takes place independent of treatment or not.