Z Orthop Unfall 2019; 157(06): 668-675
DOI: 10.1055/a-0853-2128
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Shoulder Stiffness – How to Treat?

Article in several languages: English | deutsch
Davide Cucchi
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Sebastian Gottfried Walter
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Dieter Christian Wirtz
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Max Julian Friedrich
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
› Author Affiliations
Further Information

Publication History

Publication Date:
10 July 2019 (online)

Abstract

Shoulder stiffness is a condition of restricted glenohumeral range of motion, which can arise spontaneously or as consequence of a known cause, including surgical procedures on the shoulder. Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. The aim of this review was to summarize the current concepts on conservative and operative treatment of shoulder stiffness and discuss the results of the available studies with a high level of evidence, which should be considered to guide clinical practice. Treatment of shoulder stiffness should be tailored to the patientʼs clinical situation and the stage of its shoulder pathology and should aim at pain reduction, restoration of range of motion, functional regain and shortening of symptoms duration. When possible, known risk factors for primary shoulder stiffness and causes of secondary shoulder stiffness should be addressed to avoid relapse. Conservative therapy is the mainstay of treatment for shoulder stiffness and should include a multimodal and activity-oriented program. Intra-articular injection of a low dose of corticosteroid is safe and effective, provides immediate benefits, and is recommended in combination to an appropriate rehabilitation protocol. In conservative refractory cases, arthrolysis and capsular release can be performed with an arthroscopic approach.

 
  • References/Literatur

  • 1 Itoi E, Arce G, Bain GI. et al. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy 2016; 32: 1402-1414
  • 2 Codman EA. The Shoulder: Rupture of the Supraspinatus Tendon and other Lesions in or about the subacromial Bursa. Boston: Thomas Todd Company; 1934
  • 3 Le HV, Lee SJ, Nazarian A. et al. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow 2017; 9: 75-84
  • 4 Audigé L, Blum R, Müller AM. et al. Complications following arthroscopic rotator cuff tear repair: a systematic review of terms and definitions with focus on shoulder stiffness. Orthop J Sports Med 2015; 3: 2325967115587861
  • 5 Mengiardi B, Pfirrmann CWA, Gerber C. et al. Frozen shoulder: MR arthrographic findings. Radiology 2004; 233: 486-492
  • 6 Cucchi D, Marmotti A, De Giorgi S. et al. Risk factors for shoulder stiffness: current concepts. Joints 2017; 5: 217-223
  • 7 Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975; 4: 193-196
  • 8 Neviaser TJ. Adhesive capsulitis. Orthop Clin North Am 1987; 18: 439-443
  • 9 Buchbinder R, Green S, Youd JM. et al. Oral steroids for adhesive capsulitis. Cochrane Database Syst Rev 2006; (04) CD006189
  • 10 Page MJ, Green S, Kramer S. et al. Electrotherapy modalities for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2014; (10) CD011324
  • 11 Page MJ, Green S, Kramer S. et al. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2014; (08) CD011275
  • 12 Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 2003; (01) CD004016
  • 13 Bloom JE, Rischin A, Johnston RV. et al. Image-guided versus blind glucocorticoid injection for shoulder pain. Cochrane Database Syst Rev 2012; (08) CD009147
  • 14 Buchbinder R, Green S, Youd JM. et al. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev 2008; (01) CD007005
  • 15 Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther 2010; 5: 266-273
  • 16 Robinson CM, Seah KTM, Chee YH. et al. Frozen shoulder. J Bone Joint Surg Br 2012; 94: 1-9
  • 17 Çelik D, Kaya Mutlu E. Does adding mobilization to stretching improve outcomes for people with frozen shoulder? A randomized controlled clinical trial. Clin Rehabil 2016; 30: 786-794
  • 18 Horst R, Maicki T, Trąbka R. et al. Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial. Clin Rehabil 2017; 31: 686-695
  • 19 Russell S, Jariwala A, Conlon R. et al. A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. J Shoulder Elbow Surg 2014; 23: 500-507
  • 20 Ekim AA, İnal EE, Gönüllü E. et al. Continuous passive motion in adhesive capsulitis patients with diabetes mellitus: a randomized controlled trial. J Back Musculoskelet Rehabil 2016; 29: 779-786
  • 21 Paul A, Rajkumar JS, Peter S. et al. Effectiveness of sustained stretching of the inferior capsule in the management of a frozen shoulder. Clin Orthop Relat Res 2014; 472: 2262-2268
  • 22 Chen H-C, Chuang T-Y, Lin P-C. et al. Effects of messages delivered by mobile phone on increasing compliance with shoulder exercises among patients with a frozen shoulder. J Nurs Scholarsh 2017; 49: 429-437
  • 23 Hsu W-C, Wang T-L, Lin Y-J. et al. Addition of lidocaine injection immediately before physiotherapy for frozen shoulder: a randomized controlled trial. PLoS One 2015; 10: e0118217
  • 24 Kreuz PC, Steinwachs M, Angele P. Single-dose local anesthetics exhibit a type-, dose-, and time-dependent chondrotoxic effect on chondrocytes and cartilage: a systematic review of the current literature. Knee Surg Sports Traumatol Arthrosc 2018; 26: 819-830
  • 25 Kim SH, Kim YH, Lee H-R. et al. Short-term effects of high-intensity laser therapy on frozen shoulder: a prospective randomized control study. Man Ther 2015; 20: 751-757
  • 26 Chen C-Y, Hu C-C, Weng P-W. et al. Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis. J Shoulder Elbow Surg 2014; 23: 1843-1851
  • 27 Ohta S, Komai O, Hanakawa H. Comparative study of the clinical efficacy of the selective cyclooxygenase-2 inhibitor celecoxib compared with loxoprofen in patients with frozen shoulder. Mod Rheumatol 2014; 24: 144-149
  • 28 Waldburger M, Meier JL, Gobelet C. The frozen shoulder: diagnosis and treatment. Prospective study of 50 cases of adhesive capsulitis. Clin Rheumatol 1992; 11: 364-368
  • 29 Rouhani A, Mardani-Kivi M, Bazavar M. et al. Calcitonin effects on shoulder adhesive capsulitis. Eur J Orthop Surg Traumatol 2016; 26: 575-580
  • 30 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 2010; 19: 172-179
  • 31 Ranalletta M, Rossi LA, Bongiovanni SL. et al. Corticosteroid injections accelerate pain relief and recovery of function compared with oral NSAIDs in patients with adhesive capsulitis. Am J Sports Med 2016; 44: 474-481
  • 32 Sharma SP, Baerheim A, Moe-Nilssen R. et al. Adhesive capsulitis of the shoulder, treatment with corticosteroid, corticosteroid with distension or treatment-as-usual; a randomised controlled trial in primary care. BMC Musculoskelet Disord 2016; 17: 232
  • 33 Sun Y, Zhang P, Liu S. et al. Intra-articular steroid injection for frozen shoulder: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Am J Sports Med 2017; 45: 2171-2179
  • 34 Wang W, Shi M, Zhou C. et al. Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder: a meta-analysis. Medicine (Baltimore) 2017; 96: e7529
  • 35 Sun Y, Lu S, Zhang P. et al. Steroid injection versus physiotherapy for patients with adhesive capsulitis of the shoulder: a PRIMSA systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016; 95: e3469
  • 36 Yoon S-H, Lee HY, Lee HJ. et al. Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial. Am J Sports Med 2013; 41: 1133-1139
  • 37 Kim Y-S, Lee H-J, Lee D-H. et al. Comparison of high- and low-dose intra-articular triamcinolone acetonide injection for treatment of primary shoulder stiffness: a prospective randomized trial. J Shoulder Elbow Surg 2017; 26: 209-215
  • 38 Raeissadat SA, Rayegani SM, Langroudi TF. et al. Comparing the accuracy and efficacy of ultrasound-guided versus blind injections of steroid in the glenohumeral joint in patients with shoulder adhesive capsulitis. Clin Rheumatol 2017; 36: 933-940
  • 39 Lim TK, Koh KH, Shon MS. et al. Intra-articular injection of hyaluronate versus corticosteroid in adhesive capsulitis. Orthopedics 2014; 37: e860-e865
  • 40 Park KD, Nam H-S, Lee JK. et al. Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil 2013; 94: 264-270
  • 41 Schydlowsky P, Szkudlarek M, Madsen OR. Treatment of frozen shoulder with subcutaneous TNF-alpha blockade compared with local glucocorticoid injection: a randomised pilot study. Clin Rheumatol 2012; 31: 1247-1251
  • 42 Badalamente MA, Wang ED. CORR® ORS Richard A. Brand Award: clinical trials of a new treatment method for adhesive capsulitis. Clin Orthop Relat Res 2016; 474: 2327-2336
  • 43 Yang C, Lv T, Yu T. et al. Acupuncture at Tiaokou (ST38) for shoulder adhesive capsulitis: what strengths does it have? A systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med 2018; 2018: 4197659 doi:10.1155/2018/4197659
  • 44 Koh PS, Seo BK, Cho NS. et al. Clinical effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a randomized controlled trial. J Shoulder Elbow Surg 2013; 22: 1053-1062
  • 45 Park YC, Koh PS, Seo BK. et al. Long-term effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a one-year follow-up analysis of a previous randomized controlled trial. J Altern Complement Med 2014; 20: 919-924
  • 46 Klç Z, Filiz MB, Çakr T. et al. Addition of suprascapular nerve block to a physical therapy program produces an extra benefit to adhesive capsulitis: a randomized controlled trial. Am J Phys Med Rehabil 2015; 94: 912-920
  • 47 Wu Y-T, Ho C-W, Chen Y-L. et al. Ultrasound-guided pulsed radiofrequency stimulation of the suprascapular nerve for adhesive capsulitis: a prospective, randomized, controlled trial. Anesth Analg 2014; 119: 686-692
  • 48 Yoon JP, Chung SW, Kim J-E. et al. Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial. J Shoulder Elbow Surg 2016; 25: 376-383
  • 49 Robinson PM, Norris J, Roberts CP. Randomized controlled trial of supervised physiotherapy versus a home exercise program after hydrodilatation for the management of primary frozen shoulder. J Shoulder Elbow Surg 2017; 26: 757-765
  • 50 Saltychev M, Laimi K, Virolainen P. et al. Effectiveness of hydrodilatation in adhesive capsulitis of shoulder: a systematic review and meta-analysis. Scand J Surg 2018; 107: 285-293 doi:10.1177/1457496918772367
  • 51 Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. J Shoulder Elbow Surg 2005; 14: 16-21
  • 52 Sasanuma H, Sugimoto H, Kanaya Y. et al. Magnetic resonance imaging and short-term clinical results of severe frozen shoulder treated with manipulation under ultrasound-guided cervical nerve root block. J Shoulder Elbow Surg 2016; 25: e13-e20
  • 53 De Carli A, Vadalà A, Perugia D. et al. Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?. Int Orthop 2012; 36: 101-106
  • 54 Gallacher S, Beazley JC, Evans J. et al. A randomized controlled trial of arthroscopic capsular release versus hydrodilatation in the treatment of primary frozen shoulder. J Shoulder Elbow Surg 2018; 27: 1401-1406
  • 55 Chen J, Chen S, Li Y. et al. Is the extended release of the inferior glenohumeral ligament necessary for frozen shoulder?. Arthroscopy 2010; 26: 529-535
  • 56 Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009; 25: 19-23