CAPSULITE ADESIVA OMBRO CONGELADO (MAITLAND) Clínica de Fisioterapia Dr. Robson Sitta

(11) 2528.4661 Call and schedule your appointment SUBSCRIBE on YouTube: https://www.youtube.com/channel/UCb7a... Official Website: www.fisiositta.com.br Facebook: https://www.facebook.com/fisiositta?f... LinkedIn:   / robson-sit.  . SPECIALIZED PHYSIOTHERAPY www.fisiositta.com.br (11) 2528.4661 Call and schedule your appointment SPECIALIZED PHYSIOTHERAPY Treatment of Frozen Shoulder or Adhesive Capsulitis of the Shoulder - CAO Maitland Concept Joint Capsule Mobilization Adhesive Capsulitis or Frozen Shoulder What is adhesive capsulitis or frozen shoulder? Adhesive capsulitis, commonly known as frozen shoulder, is a condition 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 its exact origin is unknown. It can also occur in patients who remain immobilized for prolonged periods. How does adhesive capsulitis occur and what happens? Adhesive capsulitis begins with inflammation, but unlike bursitis and tendonitis, it occurs in the joint capsule, the tissue that lines the entire joint. There may be a trigger for the development of capsulitis, such as minor trauma or repetitive strain. However, it can occur without any apparent cause. Adhesive capsulitis occurs in three distinct phases, each with distinct characteristics. When this inflammation occurs in the capsule, 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 severe, extremely limiting pain. Unlike tendonitis, bursitis, and impingement syndrome, any movement can cause pain, not just overhead arm movements. During this phase, shoulder movement, although painful, may still be normal. This painful phase can last up to 9 months. Next, the stiffness or freezing phase begins, during which there is a progressive loss of shoulder movement. Pain may still be present during this phase, but with less intensity. The individual feels their shoulder is shorter, unable to reach high places they previously could, and loses rotational movement, making it impossible to reach behind their back, reach for their seatbelt, or fasten their bra. This stiffness phase can last up to 12 to 18 months. Finally, there is the thawing phase, with a highly variable duration, during which shoulder movement progressively improves as the disease resolves. Natural History of Adhesive Capsulitis or Frozen Shoulder Adhesive capsulitis has always been described as a self-limiting disease. However, there are no studies of 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 two years of the disease, as published in some older scientific studies. However, this does not mean that all patients experience spontaneous improvement, nor is it clear what degree of satisfactory function is achieved, especially according to the needs of each age group. How is adhesive capsulitis or frozen shoulder diagnosed? The diagnosis is made late in many cases. It is common for patients to be diagnosed with bursitis, tendonitis, or impingement syndrome, but in fact, they are in the early stages of adhesive capsulitis, as the pain symptoms are similar to these diseases. A physical examination, which can already demonstrate loss of movement, is essential for early diagnosis, as well as a detailed clinical history, assessing the main risk factors. Imaging tests such as radiography (x-ray) or ultrasound (USG) will not demonstrate changes in adhesive capsulitis. What is the treatment for adhesive capsulitis or frozen shoulder? Treatment is non-operative in the vast majority of cases and can produce 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 focuses on stretching and improving range of motion. A common mistake is to perform intense stretching during the painful phase, as this can worsen and prolong the painful phase. A combination of some non-surgical measures can produce quick and effective results. What we call the triple procedure consists of a combination of three measures: 1. Joint injection with corticosteroids 2. Fluid distention of the joint capsule 3. Shoulder manipulation for rapid improvement in range of motion. This procedure is performed under sedation in a day hospital, with the patient being discharged 3 hours after completion.