scholarly journals Adhesive Capsulitis of the Shoulder. Is there Consensus Regarding the Treatment? A Comprehensive Review

2017 ◽  
Vol 11 (1) ◽  
pp. 65-76 ◽  
Author(s):  
Dimitrios Georgiannos ◽  
George Markopoulos ◽  
Eirini Devetzi ◽  
Ilias Bisbinas
Keyword(s):  
Conservative Management ◽  
Health Care Professionals ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Treatment Modalities ◽  
Published Evidence ◽  
Arthroscopic Capsular Release ◽  
Suprascapular Nerve Block ◽  
Manipulation Under Anaesthesia ◽  
Limiting Condition

Background:Adhesive capsulitis of the shoulder (ACS) is a common self-limiting condition characterized by disabling pain and restricted movements. Its pathophysiology is poorly understood, clinically it is characterized by stages of pain and stiffness, and finally often patients never recover fully. However, there is no consensus about available methods of treatment for ACS. The aims of this paper are to discuss and develop issues regarding approaches to management in ACS in the stages of it.Methods:A review of the literature was performed and guidelines for the treatment of that clinical entity for doctors and health care professionals are provided.Results:Anti-inflammatory medications, steroid and/or hyaluronate injections and physiotherapy is the mainstay of conservative management either alone in the first stages or in combination with other treatment modalities in the later stages. Next line of treatment, involving minor to moderate intervention, includes suprascapular nerve block, distension arthrography and manipulation under anaesthesia. In order to avoid complications of “blind intervention”, arthroscopic capsular release is gradually more commonly applied, and in recalcitrant severe cases open release is a useful option.Conclusion:Various modalities of conservative management and gradually more surgical release are applied. However, often clinicians choose on personal experience and training rather than on published evidence.

scholarly journals Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985927 ◽  
Author(s):  
Tae Wan Jung ◽  
Seung Yeop Lee ◽  
Seul Ki Min ◽  
Sang Min Lee ◽  
Jae Chul Yoo
Keyword(s):  
Nerve Block ◽  
Functional Outcomes ◽  
Constant Score ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Level Of Evidence ◽  
Simple Shoulder Test ◽  
Shoulder Range Of Motion ◽  
Suprascapular Nerve Block

Background: No therapeutic intervention is universally accepted as the most effective treatment for adhesive capsulitis. An intra-articular corticosteroid injection (IAI) with a suprascapular nerve block (SSNB), a common treatment for this disease, is a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM). Purpose: To compare the efficacy of combined SSNB and IAI with that of IAI alone in the treatment of adhesive capsulitis. Study Design: Cohort study; Level of evidence, 3. Methods: We performed a retrospective review of 102 patients with adhesive capsulitis who were treated at an outpatient clinic from July 2016 to January 2017. A combined SSNB with IAI was performed in 48 patients (SSNB + IAI group), and an IAI alone was performed in 54 patients (IAI group). Patients were assessed before the intervention and at 2 weeks and 2 months after the intervention. ROM and pain and function visual analog scales (PVAS and FVAS, respectively), the American Shoulder and Elbow Surgeons (ASES) score, the Korean Shoulder Scoring System (KSS), the Constant score, the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI) were used for clinical assessments. PVAS, FVAS, and ASES scores at a minimum of 1 year after the intervention were assessed for 82 patients. Results: At the 2-month assessment, all parameters significantly improved in both the SSNB + IAI and IAI groups ( P < .05), however, improvements in forward flexion (FF) and abduction (ABD) between the 2-week and 2-month assessments were better in the SSNB + IAI group. At the 2-month assessment, improvements in the FVAS, ASES, SST, and SPADI scores and FF and ABD values were statistically significantly greater in the SSNB + IAI group compared with the IAI group. Improvements in FVAS and ASES scores were significantly greater in the SSNB + IAI group at a minimum of 1 year. Conclusion: Both a combined SSNB and IAI and an IAI alone significantly improved pain and functional outcomes in patients with adhesive capsulitis. The use of an SSNB with an IAI further increased treatment efficacy, as per the FVAS, ASES, SST, and SPADI scores and FF and ABD values. Patients who underwent SSNB combined with an IAI showed better improvements in the FVAS and ASES scores compared with IAI alone at a minimum of 1 year after the intervention. Therefore, an SSNB combined with an IAI may be a good treatment choice for adhesive capsulitis.

Sign in / Sign up

Export Citation Format

Share Document