Conservative integrated treatment of adhesive capsulitis of the shoulder

PURPOSE: the aim of this study was to present the results of a conservative treatment for adhesive capsulitis based on an original protocol of combined pharmacological and rehabilitation treatment. METHODS: fifty-two patients with idiopathic adhesive capsulitis were enrolled in the present study. The treatment protocol included the use of hyaluronic acid and anaesthetic periarticular and intra-articular injections followed by a specific program of capsule and muscle stretching. RESULTS: the results of this treatment showed complete recovery of range of motion (ROM) in 50 of the 52 cases. The mean pre-treatment ROM values were: 85° for forward elevation, 75° for abduction, 25° for external rotation, and 15° for internal rotation. The post-treatment mean ROM values showed marked improvements: 175° for forward elevation, 175° for abduction, 87.5° for external rotation and 75° for internal rotation. CONCLUSIONS: conservative treatment of adhesive capsulitis based on a combined pharmacological and rehabilitation approach was found to be effective in resolving pain and stiffness in 96% of the patients. LEVEL OF EVIDENCE: level IV, therapeutic case series.