Adhesive Capsulitis: A New Management Protocol to Improve Passive Range of Motion

Objective: To examine the short-term efficacy of a nonoperative shoulder protocol for the treatment of adhesive capsulitis. Design: A retrospective chart review was used to collect data for a 3-year period. Setting: Academic tertiary medical center. Patients: 28 consecutive patients diagnosed as having adhesive capsulitis were identified and managed with a new protocol. Methods: The protocol consisted of the administration of a suprascapular nerve block, the subsequent injection of an intra-articular steroid, and then the injection of an anesthetic agent with brisement normal saline volume dilation. The final step was manipulation of the shoulder. Results: A paired t test was used to examine the difference in the preprocedure and postprocedure passive range of motion (flexion and abduction). The average shoulder abduction before the procedure was 89.5 degrees; this improved by an average of 51.7 degrees (P < .0001). The average shoulder flexion improved from 117.3 by an average of 37.7 degrees (P < .0001). There was no significant difference in either abduction or flexion based on age, gender, or chronicity of symptoms. White patients experienced significantly more improvement in abduction than did nonwhite patients. Conclusions: This study suggests that this adhesive capsulitis management protocol is effective and produces a significant improvement in the passive range of motion immediately after the procedure.