Capsulite Adesiva / Ombro Congelado (EVOLUÇÃO) Clínica de Fisioterapia Dr. Robson Sitta

▼ (11)2528.4661 Call and schedule your appointment Rua Coriolano 1480 - Vila Romana (Lapa), SP. Dr. Robson Sitta Physiotherapy Clinic ▼ SUBSCRIBE to our YouTube channel and receive all the news in real time: https://www.youtube.com/channel/UCb7a... ▼ Visit our official website: www.fisiositta.com.br ▼ LIKE Dr. Robson Sitta Physiotherapy Clinic on Facebook: https://www.facebook.com/fisiositta?f... ▼ ADD Robson Sitta on LinkedIn:   / robson-sit.  . SPECIALIZED PHYSIOTHERAPY in ORTHOPEDICS (MANUAL THERAPY) Clinical Evolution: Physiotherapy Treatment for Adhesive Capsulitis / Frozen Shoulder Adhesive capsulitis or frozen shoulder What is adhesive capsulitis or frozen shoulder? Adhesive capsulitis, popularly known as frozen shoulder, is a disease that causes inflammation in the shoulder joint capsule and causes pain followed by limited shoulder movement. The cause of adhesive capsulitis is related to genetic factors and autoimmune reactions, but it is not known exactly how it originates. It can also occur in patients who remain with their shoulder immobilized for a prolonged period. How does adhesive capsulitis occur and what happens? Adhesive capsulitis begins with inflammation, but unlike bursitis and tendonitis, it occurs in the joint capsule, which is the tissue that covers the entire joint. There may be some "trigger" for the development of capsulitis, such as a minor trauma or repetitive strain. However, it can occur without any apparent cause. Adhesive capsulitis occurs in 3 different phases, with different characteristics. When this inflammation in the capsule occurs, the first phase of capsulitis begins, which is the inflammatory phase. The pain may be mild at first, but within a few days or weeks it progresses to very severe and extremely limiting pain. Unlike tendonitis, bursitis and impingement syndrome, any movement can cause pain, not just movements with the arms raised. During this phase, shoulder movement, although painful, may still be normal. This painful phase can last up to 9 months. Then, the stiffness or freezing phase begins, in which there is a progressive loss of shoulder movement. There may still be pain during this phase, but of lesser intensity. The individual feels that the shoulder is shorter, cannot reach high places that it previously could, and does not lose rotational movements, being unable to put their hand behind their back, reach for the seat belt or fasten their bra. This stiffness phase can last up to 12 to 18 months. Finally, there is the thawing phase, with a very variable duration, in which shoulder movement progressively improves, with the resolution of the disease. Natural history of adhesive capsulitis or frozen shoulder Adhesive capsulitis has always been described as a self-limiting disease. However, there are no studies on its true natural history, as some type of treatment is performed in all published articles. It is known that most patients present satisfactory shoulder function after 2 years of the disease, as published in some older scientific studies. However, this does not mean that all patients present spontaneous improvement, and it is also not indicated what the degree of this satisfactory function is, especially according to the demand of each age group. How is adhesive capsulitis or frozen shoulder diagnosed? The diagnosis is made late in many cases. It is common for the patient to be diagnosed with bursitis, tendonitis or impingement syndrome, but in fact to be in an early stage of adhesive capsulitis, as the pain symptom is similar to these diseases. For early diagnosis, a physical examination is essential, which can already demonstrate a loss of movement and a detailed clinical history, evaluating the main risk factors. Imaging tests such as radiography (x-ray) or ultrasound (usg) will not show changes in adhesive capsulitis What is the treatment for adhesive capsulitis or frozen shoulder? The treatment is non-operative in the vast majority of cases and can achieve excellent results. There are several treatment options for each phase of capsulitis. As a general principle, in the painful phase, treatments should be performed to reduce pain and inflammation, and in the stiff phase, treatment is focused on stretching and gaining movement. A common mistake is to perform intense stretching in the painful phase, an attempt that can worsen and prolong this phase. The combination of some non-surgical measures can have fast and efficient results What we call the triple procedure consists of a combination of 3 measures: 1 Joint infiltration with corticosteroid 2 Water distension of the joint capsule 3 Manipulation of the shoulder to quickly gain range of movement. This procedure is performed under sedation in a day hospital, with patients being discharged 3 hours after completion.