Capsulite Adesiva do Ombro X Tendinite Calcária EXAME CLÍNICO Clínica Fisioterapia Dr. Robson Sitta

▼ Contact: (11)2528.4661 - www.fisiositta.com.br DR. ROBSON SITTA PHYSIOTHERAPY CLINIC Rua Coriolano 1480 - Vila Romana (Lapa), São Paulo (SP) - Brazil FOLLOW US ON SOCIAL MEDIA: ▼ YOUTUBE: https://www.youtube.com/channel/UCb7a... ▼ INSTAGRAM:   / robson.sitta   ▼ FACEBOOK: https://www.facebook.com/fisiositta?f... ▼ LINKEDIN:   / robson-sit.  . ▼ WEBSITE: www.fisiositta.com.br PHYSIOTHERAPY SPECIALIZED IN ORTHOPEDICS & MANUAL THERAPY Exam Clinical Adhesive Capsulitis of the Frozen Shoulder vs. Calcific Tendinopathy of the 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 limitation of 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 is known that it is much more frequent in patients with hormonal diseases, such as diabetes and thyroid diseases (hypo or hyperthyroidism), but it can occur in patients who remain with the shoulder immobilized for a prolonged period or in patients with cervical disc herniation. 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 of 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 strong and extremely limiting pain. Unlike tendonitis, bursitis and impingement syndrome, any movement can generate pain, not just movements with the arms raised. In 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 in this phase, but of lesser intensity. The individual feels that the shoulder is shorter, cannot reach high places that it previously could reach, 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 stiff phase can last up to 12 to 18 months. Finally, there is the thawing phase, which can vary in duration and in which shoulder movement gradually improves as the disease resolves. What is calcific tendonitis? Calcific tendonitis is a type of shoulder tendonitis in which calcium is deposited (calcified) in the tendon. It is a common cause of pain in patients around 40 years of age, and is more common in women. It is not related to accidents or previous trauma and is not related to other diseases. In the shoulder, this calcification occurs more in the supraspinatus tendon, followed by the infraspinatus tendon. Learn more about the anatomy of the shoulder. What is the cause of calcific tendonitis? The mechanism that generates the calcium deposit within the tendon is not known for sure. It is known that previous tendonitis may occur, associated with a temporary decrease in the vascularization of the tendon. tendinite_calcaria01.jpg What are the symptoms and how is calcific tendonitis diagnosed? Calcium deposits occur slowly over months and can cause mild pain or discomfort, similar to mild tendonitis. But very intense pain can occur suddenly. During this phase, there is the so-called reabsorption phase, in which the calcium deposit will be partially or completely reabsorbed. Not all patients go through this phase and the calcification can remain for an indefinite period within the tendon, causing symptoms similar to impingement syndrome. Diagnosis is made through X-rays with the shoulder in different rotations (internal and external), but only when the calcium deposit has already formed. Ultrasound and magnetic resonance imaging may be necessary to rule out other diseases when the X-ray does not show calcification. What is the treatment for calcific tendonitis? Treatment varies according to the symptoms and the phase of calcification. In the reabsorption phase, the most painful, there are several treatment options. Strong analgesics and anti-inflammatories are recommended. There are options for shoulder infiltrations, that is, injections with local anesthetics and corticosteroids, allowing more immediate pain relief. In the other phases, the treatment is similar to that for impingement syndrome and tendonitis, with physiotherapy and preventive measures for impingement syndrome.