Adhesive Capsulitis of Shoulder - Management

Management

Management of this disorder focuses on restoring joint movement and reducing shoulder pain, involving medications, physical therapy, and/or surgical intervention. Treatment may continue for months, there is no strong evidence to favor any particular approach. Surgical evaluation of other problems with the shoulder, e.g., subacromial bursitis or rotator cuff tear may be needed.

Medications frequently used include NSAIDs; corticosteroids are used in some cases either through local injection or systemically. Physiotherapy may include massage therapy and daily extensive stretching.

If these measures are unsuccessful manipulation of the shoulder under general anesthesia to break up the adhesions is sometimes used. Hydrodilatation or distension arthrography is controversial.Surgery to cut the adhesions (capsular release) may be indicated in prolonged and severe cases; the procedure is usually performed by arthroscopy.

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