Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments.

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Abstract

6. Psychopharmacol Bull. 2020 Oct 15;50(4 Suppl 1):91-107. doi: 10.64719/pb.4384. A Comprehensive Update of Adhesive Capsulitis and Minimally Invasive Treatment Options. Patel R(1), Urits I(1), Wolf J(1), Murthy A(1), Cornett EM(1), Jones MR(1), Ngo AL(1), Manchikanti L(1), Kaye AD(1), Viswanath O(1). Author information: (1)Patel, MD, Wolf, BS, Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ. Urits, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA. Murthy, MS, BS, Georgetown University School of Medicine, Washington, D.C. Cornett, PhD, Louisiana State University Health Sciences Center, Department of Anesthesiology, New Orleans, LA. Ngo, MD, MBA, Pain Specialty Group, Department of Pain Medicine, Newington, NH; Harvard Medical School, Boston, MA. Manchikanti, MD, Pain Management Centers of America, Paducah, KY. Kaye, Departments of Anesthesiology and Pharmacology, Toxicology and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA. Viswanath, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE. BACKGROUND: Adhesive capsulitis of the shoulder (AC) is characterized by fibrosis and contracture of the glenohumeral joint capsule, resulting in progressive stiffness, pain, and restriction of motion of the shoulder. The prevalence of AC is estimated to be 2-5% of the general population. Patients with AC typically have an insidious onset of pain and can progress to severe limitation of the shoulder leading to significant disability and decreased quality of life. OBJECTIVES: The objective of this manuscript is to provide a comprehensive review of AC with a focus on clinical presentation, natural history, pathophysiology, and various treatment modalities. STUDY DESIGN: A review article. SETTING: A review of literature. METHODS: A search was made on the Pubmed database using the keywords of adhesive capsulitis, frozen shoulder, shoulder capsulitis, arthrofibrosis, shoulder pain, shoulder stiffness. RESULTS: Our search identified numerous studies in order to provide a comprehensive review of the current understanding of the treatment and management of AC. LIMITATIONS: There remains limited evidence in literature about the understanding of AC and optimal treatment. CONCLUSION: AC is an important cause of chronic pain and disability. There is currently no consensus on treatment. Initial treatment modalities revolve around conservative measures as well as aggressive physical therapy. Further treatment options include intraarticular injections, hydro-dilation, nerve blocks, and for more refractory cases, surgical interventions such as arthroscopic capsulotomy. Copyright © 1964–2019 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States. DOI: 10.64719/pb.4384 PMCID: PMC7901130