Adhesive Capsulitis in Physical Medicine and Rehabilitation Treatment & Management
- Author: André Roy, MD, FRCPC; Chief Editor: Rene Cailliet, MD more...
Rehabilitation Program
Physical Therapy
Although studies have shown the efficacy of physical therapy, no current evidence has suggested that physical therapy alone improves function in the treatment of FS.[15, 16, 17, 18] However, physical therapy associated with an intra-articular injection of corticosteroid improves function and ROM more rapidly than does intra-articular corticosteroid injection alone.[15, 19]
Therapeutic exercises
Although many therapeutic exercises are described, few have been evaluated in the treatment of FS. Therapeutic exercises that have been studied include articular stretching and pulley therapy.[20, 21, 22] Passive articular stretching exercises improve ROM. The superiority of supervised versus home exercise programs has yet to be demonstrated.[23]
Manual therapy
Data from 2 studies support the use of manual therapy to improve ROM in the short term. One study showed that passive mobilization in the end-range position of the glenohumeral joint was more effective for improving ROM and function than was passive mobilization in the pain-free zone.[24] However, the overall difference between the interventions was small. In addition, patients appeared to achieve greatest improvement in ROM when treatment was administered early.[25]
In summary, the findings indicated that patients with FS improve with physical therapy regardless of when it is administered after the onset of FS but that they achieve the greatest improvement in their ROM when treatment is administered early.
Physical modalities
Many electroanalgesic and thermoanalgesic modalities are often used in physical therapy. Prospective, randomized, placebo-controlled clinical trials have demonstrated the inefficacy of bipolar interferential electrotherapy, TENS (transcutaneous electrical nerve stimulation) pulsed ultrasound therapy, laser therapy, and magnetotherapy with electromagnetic fields in the treatment of painful shoulder disorders. Indeed, a systematic review of randomized clinical trials has demonstrated that little evidence supports the use of common physiotherapeutic modalities to treat shoulder pain. (Nonetheless, clinical observations suggest that electroanalgesia and heat can provide some temporary relief to patients with severe shoulder pain and that they can do so without side effects.)
In summary, physical therapy alone has not been shown to improve function. However, when associated with an intra-articular corticosteroid injection, physical therapy improves ROM and function more rapidly than does intra-articular corticosteroid injection alone. The effectiveness of physical modalities has not been demonstrated. However, therapeutic exercises and manual therapy do improve ROM (see above).
Given the paucity of evidence supporting the effectiveness of physical therapy, the present authors believe that clinicians should be most conservative in designing a physical therapy program for patients with FS. An intermittently supervised, home-based articular stretching and strength-maintenance program can be combined with manual therapy, the appropriate analgesic medications, and the judicious use of electroanalgesia and warm packs. This approach generally suffices to provide adequate pain relief in most patients while the disease runs its usual, favorable course. (For additional information, see Home Exercises for the Stiff Shoulder, on the University of Washington School of Medicine Web site.
Occupational Therapy
Patients with severe FS may benefit from a referral to an occupational therapist for assistance and instruction in performing activities of daily living (ADLs). The occupational therapist helps the patient learn how to use adaptive equipment and suggest home and workplace modifications that may be necessary and beneficial for completing professional activities and routine daily tasks (eg, dressing, bathing, grooming). (See also Patient Education.) However, the effectiveness of these interventions has yet to be demonstrated. Researchers who performed a systematic review concluded that evidence supporting the effectiveness of rehabilitation in the workplace is lacking.[26]
Medical Issues/Complications
Certain authors, including the present authors, believe that idiopathic FS should be considered a distinct clinical entity. The prognosis and therapeutic approach for idiopathic FS differ from those of posttraumatic shoulder stiffening resulting from a fracture or a surgical insult to the glenohumeral joint.
Surgical Intervention
Duplay, the first person to describe the syndrome of FS, in 1872, proposed treating this condition with manipulation of the glenohumeral joint, with the patient under general anesthesia. Although some orthopedic surgeons continue to practice this technique, the benefits of this approach have not been demonstrated in controlled clinical trials.
In 1972, Hazelman noted that, in the context of a prospective controlled clinical trial, patients who had been treated with manipulation of the glenohumeral joint fared no better than did patients who received only a series of steroid injections and physical therapy.[27] Data from a long-term prospective study by Binder and colleagues seemed to support the notion that subjects who are treated with vigorous shoulder manipulation fare worse than do those who are not treated at all.[8]
A 2009 study by Jacobs et al also found no evidence that manipulation provides a better treatment outcome in FS.[28] The investigators divided 53 patients suffering from idiopathic FS into 2 groups, with one undergoing shoulder manipulation under anesthetic and the other being treated with intra-articular steroid injections and distension (see Other Treatment). After 2 years of follow-up, the investigators found no statistical difference between outcome measures in the 2 groups.
Various improvements in surgical techniques, such as the advent of controlled capsular release by using arthroscopic access to the anterior glenohumeral joint capsule and the coracohumeral ligament, appear to offer promising treatments. However, the effectiveness of these surgical techniques has yet to be demonstrated in controlled clinical trials.
Considering the favorable prognosis for patients with idiopathic FS, surgical intervention should probably be reserved for rare patients whose condition does not respond to maximal conservative modalities implemented over a sufficient period of time.[29]
Some authors propose early surgical intervention in patients with FS because of the patients' high risk of permanent contracture of the glenohumeral joint. However, this approach remains controversial because patients with diabetes often have recurring pain and contracture in the postoperative rehabilitation phase and because their rate of preoperative complications is generally increased.
Other Treatment
Studies of intra-articular and intrabursal injections, glenohumeral distension arthrography, and nerve blocks have been conducted, as described in the following text.
Intra-articular and intrabursal injections
Intra-articular corticosteroid injections
Intra-articular injections of steroid derivatives are the second most common medical intervention for treating painful joint conditions. (The most common intervention is the administration of nonsteroidal anti-inflammatory drugs [NSAIDs]). The rationale for injection of an intra-articular steroid derivative is to allow direct delivery of a modest dose of concentrated drug with analgesic and anti-inflammatory properties to the targeted site of pathology.[30] Researchers at the Manchester Rheumatology Service investigated the accuracy of a variety of joint injections that were administered by using anatomic landmarks to the upper and lower extremities. Their study demonstrated inaccurate placement of the drug in 65% of 108 joints injected.
A study by Eustace and colleagues showed results similar to those above, demonstrating that 68% of shoulder injections performed by expert specialist physicians without radiologic guidance failed to hit their target.[31] Overall, when radiologic guidance is not used, the accuracy of these injections is poor. When anatomic landmarks are used, the rate of misplacement is as high as 58% in the glenohumeral joint and as high as 69% in the subacromiodeltoidian bursae. Accuracy of the injection is associated with improved clinical results.[31, 32, 33]
If the rationale for using an intra-articular injection of steroid derivative is to deliver targeted therapy, the target in FS is the glenohumeral joint. The work by Eustace and coauthors suggests that targeted therapy that does not hit its target is not ineffective.[31] In general, however, physicians who are less experienced in joint injection than the expert rheumatologists in that study should avoid injecting shoulders without radiologic guidance. The results of their study are impressive, even for physicians who are experienced in the field of joint injections.
Eustace's study also puts an interesting twist on the interpretation of data from placebo-controlled clinical trials that failed to demonstrate favorable results with the steroid injection into the shoulder to treat FS. Some investigators did use radiologic guidance, but most employed anatomic landmarks.[15, 34, 35, 36, 37] Because some studies involved radiologic confirmation of location of the injectate, most of the injections may have missed their target. The present authors believe that no conclusions can be drawn from studies using anatomic landmarks, given the inaccuracy of the intervention.
From the current literature, we know that intra-articular corticosteroid injections or distension arthrography with corticosteroids or sodium chloride solution (discussed below) considerably improve FS in the short term. However, in the long term, they are not superior to placebo but they are superior to supervised physical therapy.[15, 38] Whether their effectiveness is the result of distension arthrography, the intra-articular corticosteroid, or their combination is unclear because most studies used corticosteroids.
Intrabursal corticosteroid injections
Many authors have shown that the pathology of FS is in the extra-articular structures, such as the coracohumeral ligament, the interval of the rotator cuff, the subacromial space, and the articular capsule.[39, 40, 41] From a pathophysiologic point of view, a rationale supports the use of corticosteroid injection in the subacromiodeltoidian bursa to treat FS.
A comparison of intra-articular and intrabursal injections with lidocaine alone or with lidocaine and a corticosteroid showed similar decreases in pain and increases in ROM in all groups.[22] However, a significant short-term decrease in pain was observed in the lidocaine-plus-corticosteroid group compared with the lidocaine-only group. Data from another study supported these findings, showing that patients whose condition did not improve with distension arthrography benefited from an intra-articular bursal injection of corticosteroid.[42]
Because of the inaccuracy of injections given by using anatomic landmarks, the present authors recommend that intra-articular and intrabursal injections should be administered by using fluoroscopic guidance. When the needle is accurately positioned, intra-articular corticosteroid injection and distension arthrography are effective in the short them. However, in the long term, they are not superior to placebo. This observation is not surprising given the favorable evolution of this disease. An intrabursal injection of corticosteroid can be used as a complementary treatment to intra-articular injection and distension arthrography or as treatment in patients whose condition does not improve with an intra-articular corticosteroid injection or with distension arthrography.
Many issues remain unclear. Factors to be resolved are whether distension is necessary, whether an intra-articular corticosteroid injection without distension (or vice versa) is enough, how many injections are needed, the stage of disease at which injections should be administered, the most effective corticosteroid, and the most effective dosage.
Intra-articular injection of sodium hyaluronate
Sodium hyaluronate has a metabolic effect on the articular cartilage, synovial tissues, and liquid. Few studies on the effect of sodium hyaluronate have been reported.[43, 44, 45] The present authors are aware of only 1 controlled study of the effectiveness of sodium hyaluronate as a sole treatment of FS. At 3 months, sodium hyaluronate was as effective as an intra-articular corticosteroid injection or physical therapy in improving function, but it was less effective than the comparators in improving ROM.[43] Although additional studies are needed before conclusions about efficacy can be drawn, intra-articular injections of sodium hyaluronate may be an alternative treatment for FS, mainly in patients in whom corticosteroid injections are contraindicated.
Glenohumeral distension arthrography
One controlled study showed no benefit to distension arthrography over intra-articular corticosteroid injection without distension.[46] Another controlled study showed a significant increase in ROM and a significant decrease in the use of analgesics after distension arthrography, compared with the use of intra-articular corticosteroid injection alone.[47]
The benefit of performing distension arthrography until the capsule ruptures must be demonstrated.[22, 48]
One uncontrolled study that was designed to examine the optimal number of distension arthrography procedures that should be performed showed that 2 procedures administered within 3 weeks, when combined with home exercises, significantly improved function. However, a third procedure offered no benefit.[49]
Another unknown factor is the stage at which infiltration should be performed. To the authors' knowledge, only 1 uncontrolled study on this question has been completed.[35] The researchers concluded that distension arthrography should be done in the second stage of disease that is not progressing, despite the patient's participation in physical therapy.
Nerve blocks
Suprascapular nerve block
The suprascapular nerve block is a simple procedure but is not well known by most clinicians.
Dangoisse's technique for suprascapular nerve block was modified to render it steroid free and accessible to most physicians who practice musculoskeletal medicine in ambulatory-care facilities and private offices. A 3.75-cm, 25-gauge needle is directed in the plane of the scapula toward the center of the floor of the supraspinous fossa. The needle-insertion point is 2 cm above the bisection point of the upper border of the spine of the scapula. After aspiration is performed to rule out intravascular needle placement, 10 mL of bupivacaine 0.5 is slowly injected into the floor of the supraspinous fossa to fill the fascial contents of this fossa and to produce an indirect suprascapular nerve block. The highly concentrated bupivacaine bathes the suprascapular nerve as it enters the fossa through the suprascapular notch.
Since 1996, thousands of bupivacaine suprascapular nerve blocks have been performed by using the above-described technique. No notable complications, other than vasovagal episodes and tenderness at the site of injection, have occurred. Most specialists in musculoskeletal medicine who treat shoulder pain in an outpatient context can safely and inexpensively perform modified indirect suprascapular nerve blocks without radiologic guidance if they are adequately trained.
A randomized controlled trial was performed to compare the effectiveness of a single suprascapular nerve block with that of series of intra-articular corticosteroid injections given by using anatomic landmarks without fluoroscopic guidance.[50] Pain decreased and ROM increased more rapidly and more completely with the nerve block than they did with the intra-articular injections.
A double-blind, placebo-controlled, randomized trial showed the superiority of 3 bupivacaine suprascapular nerve blocks.[51] At 1 month, a 64% decrease in pain was reported in the bupivacaine group compared with 13% in the placebo group. Although functional improvement was superior with bupivacaine, the difference was not statistically significant. The same authors preformed a double-blind, placebo-controlled, randomized trial larger than the previous study by using the same protocol (unpublished data). They observed no statistically significant difference between bupivacaine and placebo in terms of pain and function.
Some studies have shown the effectiveness of bupivacaine suprascapular nerve blocks to treat chronic tendinopathy of the rotator cuff, as well as to treat painful shoulders in patients with rheumatoid arthritis.[52, 53, 54] However, studies are scant, and the results are contradictory regarding the effectiveness of bupivacaine suprascapular nerve blocks in managing FS. Additional studies are needed before conclusions can be drawn.
Stellate block
An uncontrolled study of the combined effect of electropuncture, stellate block, and suprascapular nerve block showed that the combination improved pain control and increased ROM more than electropuncture or nerve block alone.[55]
Staples MP, Forbes A, Green S, et al. Shoulder-specific disability measures showed acceptable construct validity and responsiveness. J Clin Epidemiol. Aug 13 2009;[Medline].
Wohlgethan JR. Frozen shoulder in hyperthyroidism. Arthritis Rheum. Aug 1987;30(8):936-9. [Medline].
Hazleman B. Why is a frozen shoulder frozen?. Br J Rheumatol. Apr 1990;29(2):130. [Medline].
Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl. 1969;119:1-59. [Medline].
Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193-6. [Medline].
Walmsley S, Rivett DA, Osmotherly PG. Adhesive capsulitis: establishing consensus on clinical identifiers for stage 1 using the DELPHI technique. Phys Ther. Sep 2009;89(9):906-17. [Medline].
Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, et al. The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res. Oct 1995;238-48. [Medline].
Binder AI, Bulgen DY, Hazleman BL, Roberts S. Frozen shoulder: a long-term prospective study. Ann Rheum Dis. Jun 1984;43(3):361-4. [Medline]. [Full Text].
Rizk TE, Pinals RS. Frozen shoulder. Semin Arthritis Rheum. May 1982;11(4):440-52. [Medline].
Sano H, Hatori M, Mineta M, et al. Tumors masked as frozen shoulders: A retrospective analysis. J Shoulder Elbow Surg. Jun 30 2009;[Medline].
Lequesne M, Dang N, Bensasson M, et al. Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder-hand syndrome. Scand J Rheumatol. 1977;6(1):53-6. [Medline].
Binder AI, Bulgen DY, Hazleman BL, Tudor J, Wraight P. Frozen shoulder: an arthrographic and radionuclear scan assessment. Ann Rheum Dis. Jun 1984;43(3):365-9. [Medline]. [Full Text].
Mao CY, Jaw WC, Cheng HC. Frozen shoulder: correlation between the response to physical therapy and follow-up shoulder arthrography. Arch Phys Med Rehabil. Aug 1997;78(8):857-9. [Medline].
Clunie G, Bomanji J, Ell PJ. Technetium-99m-MDP patterns in patients with painful shoulder lesions. J Nucl Med. Sep 1997;38(9):1491-5. [Medline]. [Full Text].
Carette S, Moffet H, Tardif J, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum. Mar 2003;48(3):829-38. [Medline]. [Full Text].
Green S. Physiotherapy and injection better than injection alone or physiotherapy alone for improving range of motion in adhesive capsulitis. Aust J Physiother. 2003;49(2):145. [Medline].
Jürgel J, Rannama L, Gapeyeva H, et al. Shoulder function in patients with frozen shoulder before and after 4-week rehabilitation. Medicina (Kaunas). 2005;41(1):30-8. [Medline]. [Full Text].
Pajareya K, Chadchavalpanichaya N, Painmanakit S, et al. Effectiveness of physical therapy for patients with adhesive capsulitis: a randomized controlled trial. J Med Assoc Thai. May 2004;87(5):473-80. [Medline].
Ulusoy H, Sarica N, Arslan S, Olcay C, Erkorkmaz U. The efficacy of supervised physiotherapy for the treatment of adhesive capsulitis. Bratisl Lek Listy. 2011;112(4):204-7. [Medline].
Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am. Oct 2000;82-A(10):1398-407. [Medline].
Rizk TE, Christopher RP, Pinals RS, et al. Adhesive capsulitis (frozen shoulder): a new approach to its management. Arch Phys Med Rehabil. Jan 1983;64(1):29-33. [Medline].
Rizk TE, Gavant ML, Pinals RS. Treatment of adhesive capsulitis (frozen shoulder) with arthrographic capsular distension and rupture. Arch Phys Med Rehabil. Jul 1994;75(7):803-7. [Medline].
Michlovitz SL, Harris BA, Watkins MP. Therapy interventions for improving joint range of motion: A systematic review. J Hand Ther. Apr-Jun 2004;17(2):118-31. [Medline].
Vermeulen HM, Obermann WR, Burger BJ, et al. End-range mobilization techniques in adhesive capsulitis of the shoulder joint: A multiple-subject case report. Phys Ther. Dec 2000;80(12):1204-13. [Medline].
Liaw SC. The effect and timing of physiotherapy on change in range of motion and function in frozen shoulder. Physiother Singapore. Sep 2000;3(3):82-6.
Williams RM, Westmorland MG, Schmuck G, et al. Effectiveness of workplace rehabilitation interventions in the treatment of work-related upper extremity disorders: a systematic review. J Hand Ther. Apr-Jun 2004;17(2):267-73. [Medline].
Hazleman BL. The painful stiff shoulder. Rheumatol Phys Med. Nov 1972;11(8):413-21. [Medline].
Jacobs LG, Smith MG, Khan SA, et al. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg. May-Jun 2009;18(3):348-53. [Medline].
Favejee MM, Huisstede BM, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventions--systematic review. Br J Sports Med. Jan 2011;45(1):49-56. [Medline].
Lorbach O, Anagnostakos K, Scherf C, et al. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg. Sep 30 2009;[Medline].
Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O. Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. Jan 1997;56(1):59-63. [Medline]. [Full Text].
Esenyel CZ, Esenyel M, Yesiltepe R, et al. [The correlation between the accuracy of steroid injections and subsequent shoulder pain and function in subacromial impingement syndrome]. Acta Orthop Traumatol Turc. 2003;37(1):41-5. [Medline].
Naredo E, Cabero F, Beneyto P, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol. Feb 2004;31(2):308-14. [Medline].
Ryans I, Montgomery A, Galway R, et al. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford). Apr 2005;44(4):529-35. [Medline]. [Full Text].
Vad VB, Sakalkale D, Warren RF. The role of capsular distention in adhesive capsulitis. Arch Phys Med Rehabil. Sep 2003;84(9):1290-2. [Medline].
de Jong BA, Dahmen R, Hogeweg JA, et al. Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens. Clin Rehabil. Jun 1998;12(3):211-5. [Medline].
van der Windt DA, Koes BW, Devillé W, Boeke AJ, de Jong BA, Bouter LM. Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial. BMJ. Nov 7 1998;317(7168):1292-6. [Medline]. [Full Text].
Buchbinder R, Green S, Forbes A, Hall S, Lawler G. Arthrographic joint distension with saline and steroid improves function and reduces pain in patients with painful stiff shoulder: results of a randomised, double blind, placebo controlled trial. Ann Rheum Dis. Mar 2004;63(3):302-9. [Medline]. [Full Text].
Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br. 1995;77(5):677-83.
Neer CS 2nd, Satterlee CC, Dalsey RM, et al. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop. Jul 1992;(280):182-5. [Medline].
Ozaki J, Nakagawa Y, Sakurai G, et al. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am. Dec 1989;71(10):1511-5. [Medline].
Andrieu V, Dromer C, Fourcade D, et al. Adhesive capsulitis of the shoulder: therapeutic contribution of subacromial bursography. Rev Rhum Engl Ed. Dec 1998;65(12):771-7. [Medline].
Calis M, Demir H, Ulker S, et al. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis?. Rheumatol Int. Apr 2006;26(6):536-40. [Medline].
Itokazu M, Matsunaga T. Clinical evaluation of high-molecular-weight sodium hyaluronate for the treatment of patients with periarthritis of the shoulder. Clin Ther. Sep-Oct 1995;17(5):946-55. [Medline].
Rovetta G, Monteforte P. Intraarticular injection of sodium hyaluronate plus steroid versus steroid in adhesive capsulitis of the shoulder. Int J Tissue React. 1998;20(4):125-30. [Medline].
Corbeil V, Dussault RG, Leduc BE, et al. [Adhesive capsulitis of the shoulder: a comparative study of arthrography with intra-articular corticotherapy and with or without capsular distension]. Can Assoc Radiol J. Apr 1992;43(2):127-30. [Medline].
Gam AN, Schydlowsky P, Rossel I, et al. Treatment of "frozen shoulder" with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. Scand J Rheumatol. 1998;27(6):425-30. [Medline].
Bell S, Coghlan J, Richardson M. Hydrodilatation in the management of shoulder capsulitis. Australas Radiol. Sep 2003;47(3):247-51. [Medline].
Piotte F, Gravel D, Moffet H, et al. Effects of repeated distension arthrographies combined with a home exercise program among adults with idiopathic adhesive capsulitis of the shoulder. Am J Phys Med Rehabil. 2004;83(7):537-46; quiz 547-9.
Jones DS, Chattopadhyay C. Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial. Br J Gen Pract. Jan 1999;49(438):39-41. [Medline]. [Full Text].
Dahan TH, Fortin L, Pelletier M, et al. Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol. Jun 2000;27(6):1464-9. [Medline].
Emery P, Bowman S, Wedderburn L, Grahame R. Suprascapular nerve block for chronic shoulder pain in rheumatoid arthritis. BMJ. Oct 28 1989;299(6707):1079-80. [Medline]. [Full Text].
Gado K, Emery P. Modified suprascapular nerve block with bupivacaine alone effectively controls chronic shoulder pain in patients with rheumatoid arthritis. Ann Rheum Dis. Mar 1993;52(3):215-8. [Medline]. [Full Text].
Shanahan EM, Ahern M, Smith M, Wetherall M, Bresnihan B, FitzGerald O. Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain. Ann Rheum Dis. May 2003;62(5):400-6. [Medline]. [Full Text].
Lin ML, Huang CT, Lin JG, et al. [A comparison between the pain relief effect of electroacupuncture, regional never block and electroacupuncture plus regional never block in frozen shoulder]. Acta Anaesthesiol Sin. Dec 1994;32(4):237-42. [Medline].
Acquaviva P, Schiano A, Harnden P, et al. Algodystrophy: predisposition and pathogenic factors. Results of a multicentric survey concerning 765 cases [in French]. Rev Rhum Mal Osteoartic. Nov 1982;49(11):761-6. [Medline].
Vadeboncoeur. In: Dupuis M, Leclaire R, eds. Algodystrophie: Pathologie Medicale de l'Appareil Locomoteur. Medisem; 1986:562-87.
Amor B, Tallet F, Raichvarg D, et al. [Algodystrophy and metabolic anomalies]. Rev Rhum Mal Osteoartic. Nov 1982;49(11):827-33. [Medline].
Arnold JM, Teasell RW, MacLeod AP, et al. Increased venous alpha-adrenoceptor responsiveness in patients with reflex sympathetic dystrophy. Ann Intern Med. Apr 15 1993;118(8):619-21. [Medline]. [Full Text].
Binder A, Hazleman BL, Parr G, et al. A controlled study of oral prednisolone in frozen shoulder. Br J Rheumatol. Aug 1986;25(3):288-92. [Medline].
Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis. Jan 1972;31(1):69-71. [Medline]. [Full Text].
Buchbinder R, Hoving JL, Green S, et al. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis. Nov 2004;63(11):1460-9. [Medline].
Bunker TD. Frozen shoulder: unravelling the enigma. Ann R Coll Surg Engl. May 1997;79(3):210-3. [Medline].
Carrillon Y, Noel E, Fantino O, et al. Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. Rev Rhum Engl Ed. Apr 1999;66(4):201-6. [Medline].
Chapman EM, Maloof F. Bizarre clinical manifestations of hyperthyroidism. N Engl J Med. Jan 5 1956;254(1):1-5. [Medline].
Clarke GR, Willis LA, Fish WW, et al. Preliminary studies in measuring range of motion in normal and painful stiff shoulders. Rheumatol Rehabil. Feb 1975;14(1):39-46. [Medline].
de Winter AF, Jans MP, Scholten RJ, Devillé W, van Schaardenburg D, Bouter LM. Diagnostic classification of shoulder disorders: interobserver agreement and determinants of disagreement. Ann Rheum Dis. May 1999;58(5):272-7. [Medline]. [Full Text].
Doury P, Dirheimer Y, Pattin S. Algodystrophy. New York, NY: Springer-Verlag; 1984:87-95.
Doury P, Pattin S, Eulry F, et al. [Algodystrophy of the knee and scanography]. Rev Rhum Mal Osteoartic. Nov 1987;54(11):725-9. [Medline].
Green S, Buchbinder R, Glazier R, et al. Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy. BMJ. Jan 31 1998;316(7128):354-60. [Medline]. [Full Text].
Hashimoto T, Hamada T, Nakamura T, et al. Myxoid and globular degeneration of nerves in the shoulder joint. Clin Orthop. Nov 1995;(320):55-64. [Medline].
Janig W. The puzzle of reflex sympathetic dystrophy: mechanisms, hypotheses, open questions. In: Janig W, Stanton-Hicks M, eds. Reflex Sympathetic Dystrophy: A Reappraisal, Progress in Pain Research and Management. vol 6. Seattle, Wash: Int Assoc for the Study of Pain; 1996.
Jeracitano D, Cooper RG, Lyon LJ, et al. Abnormal temperature control suggesting sympathetic dysfunction in the shoulder skin of patients with frozen shoulder. Br J Rheumatol. Aug 1992;31(8):539-42. [Medline].
Jones A, Regan M, Ledingham J, Pattrick M, Manhire A, Doherty M. Importance of placement of intra-articular steroid injections. BMJ. Nov 20 1993;307(6915):1329-30. [Medline]. [Full Text].
Joshi GP, McCarroll SM. Intra-articular morphine for the management of frozen shoulder. Anaesthesia. Jul 1992;47(7):627. [Medline].
Koltzenburg M. Afferent mechanisms mediating pain and hyperalgesias in neuralgia. In: Janig W, Stanton-Hicks M, eds. Reflex Sympathetic Dystrophy: A Reappraisal, Progress in Pain Research and Management. vol 6. Seattle, Wash: Int Assoc for the Study of Pain; 1996.
Leclaire R, Bourgouin J. Electromagnetic treatment of shoulder periarthritis: a randomized controlled trial of the efficiency and tolerance of magnetotherapy. Arch Phys Med Rehabil. Apr 1991;72(5):284-7. [Medline].
Mani R, Cooper C, Kidd BL, Cole JD, Cawley MI. Use of laser Doppler flowmetry and transcutaneous oxygen tension electrodes to assess local autonomic dysfunction in patients with frozen shoulder. J R Soc Med. Sep 1989;82(9):536-8. [Medline]. [Full Text].
Manton GL, Schweitzer ME, Weishaupt D, et al. Utility of MR arthrography in the diagnosis of adhesive capsulitis. Skeletal Radiol. Jun 2001;30(6):326-30. [Medline].
Mavrikakis ME, Sfikakis PP, Kontoyannis SA, et al. Clinical and laboratory parameters in adult diabetics with and without calcific shoulder periarthritis. Calcif Tissue Int. Oct 1991;49(4):288-91. [Medline].
Mays KS, North WC, Schnapp M. Stellate ganglion blocks with morphine in sympathetic type pain. J Neurol Neurosurg Psychiatry. 1981;44:189.
Murrell GA. Scientific comment. Basic science of Dupuytren's disease. Ann Chir Main Memb Super. 1992;11(5):355-61. [Medline].
Musculoskeletal Disorders and Workplace Factors. Cincinnati, OH: Natl Inst Occup Safety and Health; Jul 1997. [Full Text].
Ochoa J, Serra J. Dorsal root reflexes: do they play a role in chronic neuropathic pain patients?. Pain Forum. 4(3):155-7.
Ogilvie-Harris DJ, Myerthall S. The diabetic frozen shoulder: arthroscopic release. Arthroscopy. Feb 1997;13(1):1-8. [Medline].
Oldham BE. Periarthritis of the shoulder associated with thyrotoxicosis. A report of five cases. N Z Med J. Dec 1959;58:766-70. [Medline].
Rizk TE, Pinals RS, Talaiver AS. Corticosteroid injections in adhesive capsulitis: investigation of their value and site. Arch Phys Med Rehabil. Jan 1991;72(1):20-2. [Medline].
Rockwood C, Mattson F III. The stiff shoulder. In: The Shoulder. 2nd ed. Philadelphia, Pa: WB Saunders; 1998:1065-7.
Ryu KN, Lee SW, Rhee YG, et al. Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography. J Ultrasound Med. Aug 1993;12(8):445-9. [Medline].
Sluka KA, Willis WD, Westlund KN. The role of dorsal root reflexes in neurogenic inflammation. Pain Forum. 1995;4(3):141-9.
Stenlund B, Goldie I, Hagberg M, et al. Shoulder tendinitis and its relation to heavy manual work and exposure to vibration. Scand J Work Environ Health. Feb 1993;19(1):43-9. [Medline].
Subbarao J, Stillwell GK. Reflex sympathetic dystrophy syndrome of the upper extremity: analysis of total outcome of management of 125 cases. Arch Phys Med Rehabil. Nov 1981;62(11):549-54. [Medline].
University of Washington School of Medicine. Home Exercises for the Stiff Shoulder. Available at http://www.orthop.washington.edu/uw/tabID__3376/ItemID__208/mid__10313/Articles/Default.aspx.
van der Heijden GJ, van der Windt DA, de Winter AF. Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trials. BMJ. Jul 5 1997;315(7099):25-30. [Medline]. [Full Text].
Vecchio PC, Adebajo AO, Chard MD, et al. Thermography of frozen shoulder and rotator cuff tendinitis. Clin Rheumatol. Sep 1992;11(3):382-4. [Medline].
Vermeulen HM, Rozing PM, Obermann WR, et al. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther. Mar 2006;86(3):355-68. [Medline].
Waldburger M, Meier JL, Gobelet C. The frozen shoulder: diagnosis and treatment. Prospective study of 50 cases of adhesive capsulitis. Clin Rheumatol. Sep 1992;11(3):364-8. [Medline].
Widiastuti-Samekto M, Sianturi GP. Frozen shoulder syndrome: comparison of oral route corticosteroid and intra-articular corticosteroid injection. Med J Malaysia. Aug 2004;59(3):312-6. [Medline].
Wilson PR, Phillip AL, Bedder MD, et al. Diagnostic algorithm for complex regional pain symptoms. In: Janig W, Stanton-Hicks M, eds. Reflex Sympathetic Dystrophy: A Reappraisal, Progress in Pain Research and Management. Int Assoc for the Study of Pain; 1996:93-105.
Zanotti RM, Kuhn JE. Arthroscopic capsular release for the stiff shoulder. Description of technique and anatomic considerations. Am J Sports Med. May-Jun 1997;25(3):294-8. [Medline].
Print
