Treatment for adhesive capsulitis, or frozen shoulder syndrome, can be done with physical therapy, pain relievers and can take 8 to 12 months of treatment, but it is also possible that there will be a complete reduction of the condition about 2 years after the onset of symptoms., even without any kind of treatment.
The doctor may recommend the use of analgesics, anti-inflammatories, corticosteroids or steroid infiltration for pain relief, but physiotherapy is also indicated and when there is no improvement in the condition, surgery may be indicated.
Adhesive capsulitis is an inflammation of the shoulder joint that causes pain and severe difficulty in moving the arm, as if the shoulder is really frozen. The diagnosis is made by the doctor after analysis of imaging tests, such as X-rays, ultrasound and arthrography, which are essential to assess shoulder mobility.
Treatment can be done with:
1. Medicines
The doctor can prescribe analgesics, non-steroidal anti-inflammatory drugs and corticosteroids in the form of pills for pain relief, in the most acute phase of the disease. Corticosteroid infiltration directly into the joint is also an option for pain relief, and because it is performed, at the average criteria, or every 4-6 months, but none of these medications excludes the need for physical therapy, being complementary.
2. Physiotherapy
Physiotherapy is always recommended because it helps to combat pain and restore shoulder movements. In physiotherapy equipment for pain relief and warm compresses can be used to facilitate the movement of this joint. Various manual techniques can be used, in addition to stretching exercises (within the pain limit) and later muscle strengthening exercises must be performed.
The recovery time varies from one person to another, but it usually lasts from a few months to 1 year, with progressive improvement of symptoms. Although there may not be a significant improvement in the range of motion with the affected arm, in the first sessions it is possible not to develop muscle contractures in the trapezius muscle that can cause even more pain and discomfort.
There are specific techniques that can help break adhesions and promote amplitude, but it is not recommended that the patient is trying to force the joint too much to move the arm, because this can generate minor trauma, which in addition to aggravating the pain, does not bring any pain. benefit. At home, only the exercises recommended by the physiotherapist should be performed, which may include the use of small equipment, such as a ball, stick (broom handle) and elastic bands (theraband).
Hot water bags are useful to place before stretching because they relax the muscles and facilitate muscle stretching, but bags with crushed ice are recommended at the end of each session because they reduce pain. Some stretches that can help are:
These exercises should be performed 3 to 5 times a day, lasting from 30 seconds to 1 minute each, but the physiotherapist can indicate others according to the needs of each person.
See some simple exercises that help to relieve shoulder pain in: Proprioception exercises for shoulder recovery.
3. Suprascapular nerve block
The doctor can perform a block of the suprascapular nerve, in the office or in the hospital, which brings great pain relief, being an option when the drugs have no effect and make physical therapy difficult. This nerve can be blocked, because it is responsible for providing 70% of the shoulder sensations, and when it is blocked there is a great improvement in pain.
4. Hydrodilation
Another alternative that the doctor can indicate is the distension of the shoulder with an injection of air or fluid (saline + corticosteroid) under local anesthesia which helps to lengthen the shoulder joint capsule, which promotes pain relief and facilitates movement shoulder
5. Surgery
Surgery is the last treatment option, when there are no signs of improvement with conservative treatment, which is done with medication and physical therapy. The orthopedic doctor may perform an arthroscopy or a closed manipulation that may return the mobility of the shoulder. After surgery the person needs to go back to physiotherapy to speed healing and continue with stretching exercises for complete recovery.
