Title: Adhesive Capsulitis of shoulder: How effective is conservative treatment

Authors: Dr Rajesh Singh, Dr Pradeep K Verma, Dr Abhi Vora

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.189

Abstract

Purpose: To study the functional outcome of conservative management in adhesive capsulitis of shoulder.

Study Design: Prospective case control study.

Material and Methods: 154 patients were divided into 2 groups. One group received only NSAIDs as medication while other group received medication and physical therapy. Patients received treatment for 3 months. Patients were evaluated after 3 months for range of movements, VAS score for pain and functional outcome with CONSTANT score.

Results: Patients receiving medication and physical therapy show better improvement in range of movements, VAS score and CONSTANT score. Improvement in VAS score and CONSTANT score is statistically significant.

Conclusion: Patients with adhesive capsulitis should be treated with physical therapy before considering for intra-articular injections or operative interventions.

Keywords: Adhesive capsulitis, frozen shoulder, physical therapy.

References

  1. Codman EA: The Shoulder: Rupture of the Supraspinatus Tendon and Other Lesions in or About the Subacromial Bursa. Boston, MA, Thomas Todd Company, 1934, p 514.
  2. Duplay S. De la peri-arthrite scapulo-humerale et des raideurs de l’epaule qui en sont la consequence. Arch Gen Med 1872;20:513-42.
  3. Neviaser JS. Adhesive capsulitis of the shoulder: a study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg 1945; 27: 211–222.
  4. Manske RC and Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med 2008;1: 180–189.
  5. McAlister I and Sems SA. Arthrofibrosis after periarticular fracture fixation. Orthop Clin N Am 2016; 47: 345–355.
  6. Constant CR, Murley AGH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;(214): 160-4
  7. D. Gould et al. Visual Analogue Scale (VAS). Journal of Clinical Nursing 2001; 10:697-706
  8. PERIARTHRITIS OF THE SHOULDER By JOHN CHARNLEY. Postgrad med j.1959,384-388
  9. Neviaser AS and Neviaser RJ. Adhesive capsulitis of the shoulder. J Am Acad Orthop Surg 2011; 19: 536–542.
  10. The rotator interval: anatomy, pathology, and strategies for treatment. J Am Acad Orthop Surg 2007; 15: 218–227.
  11. Hunt SA, Kwon YW and Zuckerman JD. The rotator interval: anatomy, pathology, and strategies for treatment. J Am Acad Orthop Surg 2007; 15: 218–227.
  12. Neer CS 2nd, Satterlee CC, Dalsey RM, et al. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res 1992;280: 182–185
  13. Ozaki J, Nakagawa Y, Sakurai G, et al. Recalcitrant chronic adhesive capsulitis of the shoulder: role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 1989; 71: 1511–1515.
  14. Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017;9(2):75–84
  15. Vermeulen HM, Obermann WR, Burger BJ, Kok GJ, Rozing PM, van den Ende CHM. End-range mobilization techniques in adhesive capsulitis of the shoulder joint: a multiple-subject case report. Phys Ther. 2000;80:1204–13.
  16. Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis: a prospective functional outcome study of non-operative treatment.J Bone Joint Surg Am. 2000;82:1398–407.
  17. Diercks RL, Stevens M. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg. 2004;13:499–502.

Corresponding Author

Dr Rajesh Singh

Dept of orthopaedics, Shaym Shaw Medical College, Rewa, India