Adhesive capsulitis of shoulder

src: i.ytimg.com

Capsulitis adhesive (also known as frozen shoulder) is a painful and crippling disorder of an obscure cause in which the shoulder capsule, the connective tissue that surrounds the glenohumeral joint of the shoulder, becomes inflamed and stiff , severely restricts movement and causes chronic pain. Pain is usually constant, worse at night, and with cold weather. Certain movements or bulges can provoke extraordinary episodes of pain and cramps. This condition is thought to be caused by injury or trauma to the area and may have an autoimmune component.

Risk factors for frozen shoulder include tonic seizures, diabetes mellitus, stroke, accidents, lung disease, connective tissue disease, thyroid disease, and heart disease. Treatment may be painful and exhausting and consists of physical therapy, occupational therapy, medication, massage therapy, hydrodilation or surgery. A doctor can also perform manipulations under anesthesia, which breaks down the adhesion and scar tissue in the joint to help restore some range of motion. Alternative treatments exist such as the Trigenika OAT Procedure, ART, and OTZ methods. But this can vary in success depending on the type and severity of the frozen shoulder. Pain and inflammation can be controlled with analgesics and NSAIDs.

People who have adhesive capsulitis usually experience severe pain and lack of sleep for long periods of time because of increasingly worsening pain when lying still and restricting movement/position. This condition can cause depression, problems in the neck and back, and severe weight loss due to lack of sleep in the long run. People who have adhesive capsulitis may have extreme difficulty concentrating, working, or performing activities of daily life for long periods of time. These conditions tend to limit themselves and usually heal over time without surgery. Most people regain about 90% of shoulder movement over time.

Video Adhesive capsulitis of shoulder

Signs and symptoms

The shoulder movement is very limited, with progressive loss of both active and passive motion. This condition is sometimes caused by injury, causing a lack of use due to pain, but also often spontaneously arises without a clear trigger factor (idiopathic frozen shoulder). The development of rheumatic diseases and recent shoulder surgery can also cause pain patterns and limitations similar to frozen shoulders. Intermittent use can cause inflammation.

On the frozen shoulder, there is a deficiency of synovial fluid, which usually helps the shoulder joints, balls and socket joints, move by lubricating the gap between the humerus (the upper arm bone) and the socket in the shoulder blade. The shoulder caps thickens, swells, and tightens because of the scar tissue (adhesion) formed inside the capsule. As a result, there is less room in the joints for the humerus, making stiff shoulder movements and pain. This confined space between the capsule and the humerus ball distinguishes the adhesive capsulitis from the more elaborate, painful, and rigid shoulders.

Maps Adhesive capsulitis of shoulder

Diagnosis

One sign of a frozen shoulder is that the joint becomes very tight and rigid, making it almost impossible to perform simple movements, such as lifting arms. A very obstructed movement is the external rotation of the shoulder.

People complain that the stiffness and pain worsen at night. Pain due to frozen shoulder is usually dull or ill. This can be exacerbated by attempted movements, or if collided. A physical therapist, osteopath or chiropractor, doctor, physician assistant, or nurse practitioner can expect a patient to have a frozen shoulder if a physical examination shows limited shoulder movement. A frozen shoulder can be diagnosed if the range of active motion range (range of motion from active use of muscle) is equal to or nearly equal to the range of passive motion (the range of motion of a person who manipulates the arm and shoulder). An arthogram or MRI scan program can confirm the diagnosis, although in practice it is rarely necessary.

The frozen shoulder shoulder normal road has been described as having three stages: First stage: The "frozen" or painful stage, which can last from six weeks to nine months, and where the patient experiences a slow onset of pain. When the pain gets worse, the shoulder loses motion.

Phase two: The "frozen" or adhesive level is characterized by a slight increase in pain but stiffness. This stage usually lasts from four to nine months.

Phase three: "Dilution" or recovery, when shoulder movement slowly returns to normal. It usually lasts from 5 to 26 months.

​​â € <â €

The imaging features of adhesive capsulitis are seen in non-contrast MRI, although MR arthrography and invasive arthroscopy are more accurate in diagnosis. Ultrasound and MRI may assist in diagnosis by assessing the coracohumeral ligament, with widths greater than 3 mm to 60% sensitive and 95% specific for diagnosis. This condition can also be associated with edema or fluid at the rotator interval, the space in the shoulder joint usually contains fat between supraspinatus and subscapularis tendon, medial to rotator cuff. Shoulder with capsulitis adhesive is also typical of fibroids and thickened in the armpit pocket and rotator interval, best seen as a dark signal on the T1 sequence with edema and inflammation in the T2 sequence. The finding on ultrasound associated with capsulitis adhesives is a hypoechoic material that surrounds the long head of the biceps tendon at the rotator interval, reflecting fibrosis. In painful stages, the hypoechoic substance may show increased vascularization with Doppler ultrasound.

src: www.kinetesisspineandjoint.ca

Prevention

To prevent this problem, a general recommendation is to keep the shoulder joint fully movable to prevent frozen shoulders. Often the shoulder will hurt when it begins to freeze. Because pain inhibits movement, further development of restricted motion adhesion will occur unless the joint continues to move fully in all directions (adduction, abduction, flexion, rotation, and extension). Physical therapy and occupational therapy can help with further movement.

However, a 2004 study showed that "ignored oversight" had a higher recovery rate than physical therapy and passive stretching.

src: viewmedica.com

Management

Management of this disorder focuses on restoring joint motion and reducing shoulder pain, involving drugs, physical therapy, and/or surgical intervention. Treatment may continue for months, there is no solid evidence to support a particular approach.

Commonly used drugs include NSAIDs; Corticosteroids are used in some cases either by local or systemic injection. Manual therapists such as osteopaths, chiropractors, and physiotherapists can include massage therapy and extensive stretching every day. Another osteopathic technique used to treat the shoulder is called the Spencer technique.

If these steps do not work, shoulder manipulation under general anesthesia to break adhesion is sometimes used. Hydrodilation or controversial distillation artrography. Surgery for cutting adhesion (capsule release) may be indicated in prolonged and severe cases; this procedure is usually done by Artroscopy. Surgical evaluation of other problems with the shoulder, for example, subacromial bursitis or rotator cuff rip may be required.

A study published in 2004 by Diercks and Stevens showed that "oversight oversight" has the possibility of a full recovery; for twenty-four months, "negligence overseen" resulted in a 89% recovery rate than intense physical therapy and passive stretching, which showed only a 63% recovery rate.

src: www.progressivespineandsports.com

Epidemiology

The incidence of adhesive capsulitis is about 3 percent in the general population, but some researchers doubt these often quoted figures because of how often the disease is misdiagnosed; this will make the disease less frequent than previously thought. Occurrence is rare in children and people under 40 but peaks between 40 and 70 years. At least in idiopathic form, the condition is much more common in women than in men (70% of patients are women aged 40-60). Frozen shoulder is more common in diabetic patients and is more severe and more prolonged than in non-diabetic populations.

People with diabetes, stroke, lung disease, rheumatoid arthritis, or heart disease are at a higher risk for frozen shoulder. Injury or surgery to the shoulder or arm may cause damage to blood flow or capsule to tighten from reduced use during recovery. Capsulitis adhesive has been indicated as a possible side effect of some form of highly active antiretroviral therapy (HAART). Cases have also been reported after breast and lung surgery.

src: i.ytimg.com

See also

• calcine tendinitis
• Milwaukee's shoulder syndrome

src: c8.alamy.com

References

Artikel ini berisi teks dari dokumen domain publik "Frozen Shoulder", American Academy of Orthopedic Surgeons.

src: c8.alamy.com

Bacaan lebih lanjut

• Siegel, Lori B.; Cohen, Norman J.; Gall, Eric P. (1999). "Adhesive capsulitis: masalah yang sulit". Dokter Keluarga Amerika . 59 (7): 1843-52. PMID 10208704.
• Urutan gambar radiologi yang menunjukkan hidrodilatasi bahu terpandu CT
• "Adhesive Capsulitis" dari Arend CF. Ultrasound Bahu. Master Medical Books, 2013.
• Perawatan "Neuromanual" untuk bahu beku menggunakan anestesi lokal dari Russian Journal of Manual Therapy, 2012

src: www.theaark.co.uk

Tautan eksternal

Source of the article : Wikipedia