Evaluation of the impact of osteopathic techniques and physical exercises on the range of motion and sensation of pain in the frozen shoulder - a case report

Ból ◽  
2017 ◽  
Vol 17 (4) ◽  
pp. 53-58
Author(s):  
Mateusz W. Romanowski ◽  
Michał Dwornik ◽  
Anna Kwaśniewska ◽  
Katarzyna Nowacka ◽  
Włodzimierz Samborski
Keyword(s):  
Range Of Motion ◽  
Clinical Symptoms ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Treatment Options ◽  
Frozen Shoulder ◽  
Physical Exercises ◽  
Effective Form ◽  
The Impact

ABSTRACT: This research presents the case of a patient with a frozen shoulder and assesses the impact of osteopathic techniques and physical exercises for this condition. The article describes the epidemiology, etiology, pathogenesis, clinical symptoms and treatment options for frozen shoulder. It also contains information on how to conduct clinical tests and diagnosis of the adhesive capsulitis. We assessed the range of flexion, external rotation, internal rotation and the intensity of pain of the patients frozen shoulder. In this case study frozen shoulder developed typically, in three stages “freezing”, “frozen”, “thawing”. The treatment significantly increased the range of motion of the shoulder joint and reduced sensation of pain. The analysis shows that the osteopathic techniques and physical exercises are an effective form of rehabilitation and pain management. Further studies are needed in this area.

scholarly journals Factors Affecting the Outcomes of Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986762 ◽  
Author(s):  
Syed M. Rizvi ◽  
Ahmed J. Harisha ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Linear Regression Analysis ◽  
Frozen Shoulder ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Background: Arthroscopic capsular release has been shown to provide excellent short- and long-term outcomes in patients with idiopathic frozen shoulder. Some surgeons delay surgery in the belief that operating in the early stages of adhesive capsulitis results in a poorer prognosis. However, it is unclear which factors, particularly the stage of the disorder, affect the surgical outcome of this procedure. Hypothesis: Patients who undergo capsular release during the early symptomatic stage of idiopathic adhesive capsulitis would have less improvement in range of motion compared with those who undergo surgery at a later stage. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 189 shoulders with idiopathic adhesive capsulitis that underwent arthroscopic capsular release were evaluated. All patients completed a L’Insalata questionnaire and had their range of motion and strength tested prior to surgery and at 1, 6, and 12 weeks and 6 months post–capsular release. Post hoc, patients were grouped by whether they had symptoms lasting <10 months (shorter symptoms group; n = 131) or ≥10 months (longer symptoms group; n = 38). Multiple linear regression analysis was performed to determine which preoperative factors were independently associated with a favorable outcome. Results: Patients in the shorter symptoms group were more restricted prior to surgery than were those in the longer symptoms group (mean ± SEM: external rotation, 17° ± 2° vs 27° ± 4° [ P = .04]; abduction, 78° ± 3° vs 92° ± 6° [ P = .04]; internal rotation, S3 ± 1 vs S1 ± 1 [ P = .03]). The shorter symptoms group had greater postoperative improvement in internal rotation (from S3 ± 1 preoperatively to T12 ± 1 vertebral levels) compared with the longer symptoms cohort (from S1 ± 1 to L2 ± 1) ( P = .02). Conclusion: Patients with a frozen shoulder and a duration of symptoms <10 months made greater improvements in internal rotation and had similar final results for flexion, abduction, and external rotation following arthroscopic capsular release when compared with patients who had a longer duration of symptoms, so there is no reason to delay surgery.

Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis

2020 ◽  
pp. 175857322097717
Author(s):  
Daoud Makki ◽  
Mustafa Al-Yaseen ◽  
Fayaz Almari ◽  
Puneet Monga ◽  
Lennard Funk ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Number Of Patients ◽  
Post Traumatic

Background Adhesive capsulitis (frozen shoulder) is characterised by pain and loss of range of motion of the glenohumeral joint. It can be present as primary (idiopathic) or secondary to surgery, trauma or other conditions that restrict the use of the shoulder joint. Various treatment options have been adopted including physiotherapy, manipulation under anaesthetic, hydrodilatation and arthroscopic or open capsular release but the optimal form of management remains uncertain. Objectives The purpose of the study was to assess the clinical outcome of glenohumeral hydrodilatation in three cohorts of patients with different aetiologies with adhesive capsulitis. Study design & methods We carried out a retrospective study of patient who underwent hydrodilatation for adhesive capsulitis between 2013 and 2015. The procedure was performed by a specialist musculoskeletal radiologist under radiological guidance. The injection consisted of steroids, local anaesthetics and NaCl solution with a target volume around 35 mL. Our outcome measures were range of motion, and pre- and post-operative pain. Patients were divided into three groups based on the presumed cause of their stiffness: idiopathic, post-traumatic and post-surgical. Results Two hundred fifty patients were included, with a mean age of 59 years (range: 20–79). Of these, 180 had idiopathic primary adhesive capsulitis (27 were diabetic), 23 were post-traumatic, and 20 following surgical procedures. Thirty-four required further intervention following initial hydrodilatation with 8 undergoing repeat hydrodilatation, and 26 requiring arthroscopic capsular release. The diabetic group accounted for 16 capsular releases and 4 repeat procedures, while the idiopathic group accounted for 9 and 4, respectively. One patient required capsular release in the surgical group. An improvement was recorded in ROM in all groups with mean abduction improving from 59° to 110°, flexion from 50° to 120° and external rotation from 20° to 50°. With regards to pain, the majority showed an improvement from severe or moderate pain to no or mild pain. Conclusions Results show that hydrodilatation resulted in an improvement in all outcome measures, with only a small number of patients, especially those with diabetes, needing further procedures or showing no improvement in range of motion and pain. There was no difference between the post-traumatic and post-surgical groups.

scholarly journals Effect of Hijamah (Dry Cupping) on Frozen Shoulder: A Case Study

2021 ◽  
Vol 08 (1&2) ◽  
pp. 14-17
Author(s):  
Mohammad Abid ◽  
Keyword(s):  
General Population ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Clinical Presentation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Left Shoulder ◽  
Radiological Assessment ◽  
Common Causes

Frozen shoulder or adhesive capsulitis is one of the most common causes of shoulder pain and disability in the general population. Its prevalence is 2-5% in the general population and 10-20% among diabetics. It predominantly affects females and most commonly affects people between the ages of 40 and 60 years. The left shoulder is more likely to be affected, with both shoulders affected in 12% of cases. A case study is presented to illustrate the clinical presentation, aetiology, diagnosis, radiological assessment, and management of frozen shoulder through Hijamah bila shurt (dry cupping) in a 60-year-old diabetic male patient. The present case was studied for over 8 weeks; Hijamah (dry cupping) was done on prescribed points for the affected shoulder twice a week for 8 weeks, and assessment was done at baseline and every 2 weeks. This study concluded that regimental therapy Hijamah bila shurt (dry cupping) has a significant effect in reducing pain, stiffness of joints, and increasing range of motion in frozen shoulder.

scholarly journals Restriction of Passive Glenohumeral Abduction Combined With Normal Passive External Rotation Is a Diagnostic Feature of Calcific Tendinitis

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775290 ◽  
Author(s):  
Anna Jungwirth-Weinberger ◽  
Christian Gerber ◽  
Glenn Boyce ◽  
Thorsten Jentzsch ◽  
Simon Roner ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Salient Feature ◽  
Supraspinatus Tendon ◽  
Calcific Tendinitis ◽  
Diagnostic Feature ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Standardized Protocol

Background: Passive glenohumeral range of motion may be characteristically limited to specific shoulder pathologies. While pain associated with loss of range of passive external glenohumeral rotation is recognized as a salient feature in adhesive capsulitis, restriction of glenohumeral range of motion in calcific tendinitis of the supraspinatus tendon has never been studied. Hypothesis: On the basis of clinical observation, we hypothesized that calcific tendinitis of the supraspinatus tendon is associated with loss of passive glenohumeral abduction without loss of external rotation. Study Design: Cohort study; Level of evidence, 3. Methods: Ranges of passive glenohumeral rotation and abduction, which are measured with a standardized protocol in our institution, were retrospectively reviewed and compared for patients diagnosed with either adhesive capsulitis or calcific tendinitis of the supraspinatus tendon. A total of 57 patients met the inclusion criteria for the calcific tendinitis, and 77 met the inclusion criteria for the adhesive capsulitis group. Results: When compared with the contralateral, unaffected shoulder, glenohumeral abduction in the calcific tendinitis group was restricted by a median of 10° (interquartile range [IQR], –20° to –5°) as opposed to glenohumeral external rotation, which was not restricted at all (median, 0°; IQR, 0° to 0°). The adhesive capsulitis group showed a median restriction of glenohumeral abduction of 40° (IQR, –50° to –30°) and a median restriction of passive glenohumeral external rotation of 40° (IQR, –60° to –30°). Conclusion: Calcific tendinitis of the supraspinatus does not typically cause loss of external rotation but is frequently associated with mild isolated restriction of abduction. This finding can be used to clinically differentiate adhesive capsulitis from calcific tendinitis.

scholarly journals COMPARISON OF INTRA-ARTICULAR METHYLPREDNISOLONE AND KETOROLAC INJECTIONS IN IMPROVING RANGE OF MOTION FOR DIFFERENT SHOULDER JOINT DISORDERS

2021 ◽  
Vol 71 (3) ◽  
pp. 819-22
Author(s):  
Sumeera Matee ◽  
Wasif Anwar ◽  
Sami Wahid ◽  
Saeed Bin Ayaz ◽  
Rana Shahid ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Military Hospital ◽  
Prednisolone Acetate ◽  
Methyl Prednisolone ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Flexion Extension

Objective: To compare the efficacy of intra-articular injection of methyl prednisolone with ketorolac for improvement in range of motion in various shoulder joint disorders. Study Design: Quasi-experimental study. Place and Duration of Study: Departments of Internal and Rehabilitation Medicine, Combined Military Hospital Mangla, from Nov 2018 to May 2019. Methodology: Through non-probability consecutive sampling, patients with shoulder disorders were enrolled in the study and divided into two groups. Group A received intra articular corticosteroid injection and group B received intra-articular Ketorolac injection. Outcome was measured in terms of improvement in shoulder range of motion. Results: A total of 60 patients were selected, 40 (66.7%) male and 20 (33.3%) female. 30 (50%) patients had adhesive capsulitis, 24 (40%) had rotator cuff syndrome and 6 (10%) had impingement syndrome. 24 patients received methyl prednisolone acetate injection while 36 received ketorolac injection. There was no significant difference in the mean gain in flexion, extension, abduction, internal or external rotation between both groups (p=0.224, p=0.261, p=0.884, p=0.238, and p=0.584 respectively). Conclusion: There was no significant difference in efficacy of corticosteroid and ketorolac when injected intra-articularly in shoulder joint disorders.

scholarly journals PREVALENCE AND MANAGEMENT OF THE DIABETIC FROZEN SHOULDER

2020 ◽  
Vol 8 (10) ◽  
pp. 944-954
Author(s):  
Niraj Kumar ◽  
Keyword(s):  
Functional Ability ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Treatment Strategies ◽  
Insidious Onset ◽  
Group A ◽  
Shoulder Syndrome ◽  
Shoulder Condition ◽  
Group B

The term frozen shoulder was first introduced by Codman in 1934. He described a painful shoulder condition of insidious onset that was associated with stiffness and difficulty sleeping on the affected side. Codman also identified the marked reduction in forward elevation and external rotation that are the hallmarks of the disease. Long before Codman, in 1872, the same condition had already been labelled periarthritis by Duplay. In 1945, Naviesar coined the term adhesive capsulitis. [2] The pathophysiology of idiopathic adhesive capsulitis (frozen shoulder) is poorly understood. Most authors have reported various degrees of inflammatory changes in the synovial membrane. Adhesions between the shoulder capsule and the humeral head have been noted by some, but not all, authors. [4] The aetiology of periarthritis of the shoulder, however, is not clearly understood. Amongst the factors suggested are trauma myocardial infarction hemiplegia, pulmonary tuberculosis, thyrotoxicosis, cerebral tumour, and epilepsy. [7] Subjects with Frozen Shoulder Syndrome group A treated with ERM and MWM and group B treated with MRM. The duration of each treatment was 3 weeks. There was an improvement in mobility and functional ability at 12 weeks in subjects treated with the 3 mobilization techniques. Comparing the effectiveness of the 3 treatment strategies in subjects with unilateral Frozen Shoulder Syndrome, ERM and MWM were more effective than MRM in increasing mobility and functional ability. [22].

scholarly journals A case study of frequent leech application in diabetes mellitus with special reference to frozen shoulder

2018 ◽  
Vol 6 (02) ◽  
Author(s):  
Rashmi Anil Kale ◽  
Chetan Pralhad Agrawal
Keyword(s):  
Diabetes Mellitus ◽  
Severe Pain ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Limited Range ◽  
Shoulder Impingement ◽  
Rotator Cuff Tendinitis ◽  
Shoulder Region ◽  
Aggregation Inhibitor

In Frozen Shoulder (adhesive capsulitis), there is stiffness, pain and limited range of movements. It may happen after an injury, overuse of joint, from a disease such as diabetes or a stroke. Diabetes mellitus is a group of metabolic disorder with involvement of musculoskeletal system. In which most common is frozen shoulder. In frozen shoulder raise sugar in blood stick to collagen and restrict the movements. In first stage of frozen shoulder, Inflammation of capsule is present with severe pain.           Various diseases like Shoulder Impingement, Frozen Shoulder, and Rotator cuff tendinitis have resembling symptoms under the umbrella of disease Avabahuka described in Ayurveda. In Avabahuka there is Vata-Kapha dushti still Leech application was carried out in first stage of Frozen Shoulder. Leech application is indicated in Pittaj Dushthi and Hirudine present in saliva of Leech helpful in platelet aggregation inhibitor. Hence increase in blood supply to shoulder region may arrest fibrosis of capsule. Aim- Study the efficacy of Leech application in Frozen Shoulder in Diabetes Mellitus. Objective- To study the efficacy of frequent Leech application in the management of pain and range of motion of shoulder joint in Diabetes Mellitus. Hypothesis- Leech application is effective in Frozen Shoulder caused by diabetes Mellitus.  

scholarly journals Spinal Cord Stimulation for Complex Regional Pain Syndrome: A Case Study of a Pregnant Female

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E487-E493
Author(s):  
Shaik Ahmed
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Conclusive Evidence ◽  
Treatment Modalities ◽  
Child Bearing ◽  
The Impact

Background: Spinal cord stimulation (SCS) is a form of neuromodulation, used to treat chronic neuropathic pain refractory to conventional medical management. Spinal cord stimulators are treatment options when intractable chronic pain has not responded to more conventional treatment modalities. Currently, the use of SCS is contraindicated in pregnancy. Nevertheless, many SCS/ neuromodulation recipients are women of child bearing age who may become pregnant. There are no published reports that focus on the possible side effects of SCS or neuromodulation therapy on human fertility, fetal development, pregnancy, delivery, or lactation. Objectives: The purpose of this current report is to present a case study on the use of SCS/ neuromodulation during pregnancy. Study Design: Presentation of the case of a 24 year old female who became pregnant after receiving an SCS implantation for pain control secondary to complex regional pain syndrome (CRPS). The SCS was in use at the time of conception but deactivated when patient became aware of her pregnancy and intermittently reactivated for five minute intervals throughout the entire pregnancy. Results: Currently very little documented evidence is available regarding the safety of using a SCS/ neuromodulator during pregnancy; therefore its use during pregnancy is contraindicated. Available literature suggests that, women who have chosen to keep the SCS/neuromodulator activated during pregnancy have delivered healthy babies without any life threatening complications. Limitations: Case presentations do not provide conclusive evidence of treatment effectiveness. This data is only preliminary and future studies should be used to assess outcomes and measures to provide quantification of the SCS implantation during pregnancy. Conclusions: Women of child bearing age who are recipients of SCS/neuromodulation implantation should be informed of the limited knowledge available regarding the impact of SCS/ neuromodulation use during pregnancy. For current recipients, decisions about ongoing use during pregnancy should be an individual decision based on the potential risks and benefits. Key words: Pregnancy and complex regional pain syndrome, pregnancy and reflex sympathetic dystrophy, pregnancy and spinal cord stimulators, pregnancy and electromagnetic fields, and pregnancy and neuromodulator.

scholarly journals Role of Phonophoresis in Management of Adhesive Capsulitis (Frozen Shoulder)

2014 ◽  
Vol 13 (2) ◽  
pp. 21-27
Author(s):  
Sunam Kumar Barua ◽  
Sohely Rahman ◽  
Prashanta Kumar Chakrabarti ◽  
Zahangir Alam
Keyword(s):  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Medical College Hospital ◽  
Physical Medicine ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Group A ◽  
Group B

This prospective study was performed in the department of Physical Medicine, Dhaka Medical College Hospital (DMCH), Dhaka for a period of 6 months to see the effect of phonophoresis (Ultrasound therapy with Naproxen gel) on adhesive capsulitis. During this period 240 (4% of total patients) patients were diagnosed as adhesive capsulitis of shoulder in outpatient department, Physical Medicine, Dhaka Medical College Hospital. Sixty patients were selected for the study and divided them into two groups. In group A, patients were treated with phonophoresis and exercises in contrast with group B patients who were treated with same exercises without phonophoresis for same duration. Patients in both groups were followed up weekly for consecutive six weeks. The mean age of the patients in this study was 51.73 ± 10.01 year, with a range of 35 to 70 years. Out of sixty patients 31 (51.7%) were male and 29 (48.3%) were female. The male: female ratio was 1.07: 1. Among 60 patients, 27 (45%) were housewives, 20 (33.3%) service holders (official job), 4 (6.7%) businessmen, 1 (1.7%) teacher and 8 (13.3%) retired persons. In this study 53.3% patients had right shoulder involvement and rest of them (46.7%) had left sided involvement. Pain was improved just after initiation of treatment and it was completely alleviated in group A patients after 6th week, on the contrary although pain was increased after 1st week of treatment thereafter it was gradually decreased but it was not completely alleviated in group B patients at the end of the study. All sorts of range of motions (abduction, internal rotation on abduction, external rotation on abduction) of affected shoulder were improved more rapidly in group A compared to group B patients. Shoulder pain and disability index (SPADI) were significantly reduced in group A compared to group B patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21057

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