ADHESIVE CAPSULITIS /frozen shoulderppt.pptx

Adhesive Capsulitis or frozen shoulder is a very common painful condition affecting capsule of shoulder joint.

1. ANKITA NIGAM MPT NEUROLOGY SR. PHYSIOTHERAPIST KHUSHILAL AYURVEDIC HOSPITAL BHOPAL ADHESIVE CAPSULITIS (FROZEN SHOULDER)

2. INTRODUCTION As the name suggest , in this condition shoulder becomes “frozen” or “ stiff “. It is a common debilitating condition characterized by shoulder pain and progressive loss of shoulder movement The condition, medically known as adhesive capsulitis , occurs in roughly 2% of the general population and usually in women between the ages of 40 and 60. जैसा कि नाम से पता चलता है, इस स्थिति में कंधा "जमा हुआ" या "कठोर" हो जाता है। यह स्थिति, जिसे चिकित्सकीय रूप से एडहेसिव कैप्सुलिटिस के रूप में जाना जाता है, सामान्य आबादी के लगभग 2% में होती है और आमतौर पर 40 से 60 वर्ष की आयु के बीच की महिलाओं में होती है।

3. Frozen shoulder is characterized by fibroproliferative tissue fibrosis, whereby fibroblasts, producing predominantly type I and type III collagen, transform into myofibroblasts (a smooth muscle phenotype), which is accompanied by inflammation, neoangiogenesis and neoinnervation, resulting in shoulder capsular fibrotic contractures and the associated clinical stiffness .

4. INTRODUCTION

5. STAGES OF FROZEN SHOULDER With Frozen Shoulder, there are typically three stages: Freezing Stage : 6- 9 weeks Frozen Stage: usually lasts 4 – g month Thawing Stage: 6 month – 2 years Shoulder becomes increasingly painful, and you slowly lose range of motion This stage immediately follows the freezing stage and is usually less painful though the stiffness remains. daily activities become difficult This stage is where the shoulder slowly improves with either a complete return to normal or close to normal strength and motion. लक्षण : तेज दर्द कंधे को हिलाने एवं चलाने में परेशानी होना लक्षण : तेज दर्द कंधे को हिलाने चलें ऊपर उठें, पीछे लेजाने में असमर्थ होना लक्षण : हल्का दर्द कंधे को चलने में पहले से आसान होना चाहिए

6. Imaging

7. TREATMENT OPTIONS AVAILABLE As per latest treatment available ,mentioned by Niel L Miller et al on Nature Reviews Disease Primers   volume 8 , Article number: 59 (2022) on for frozen shoulder till 8 sept 2022 Management consists of physiotherapy steroid injections anti-inflammatory medications Hydrodilation and surgical interventions

8. PHYSIOTHERAPY INTERVENTION Quite essential in all the stages . Provided in form of Electrotherapy Precise prescribed exercise regimen for clinical set up and home , according to stage and individual condition Specialized manual techniques like PRT , stretching , mulligan mobilization of shoulder and scapula , graston technique manipulation Deep tissue massage( deep friction by james cyriax ) for adhesion Dry needling / cupping / taping techniques for pain and adhesion Cryotherapy etc

9. Importance of Deep Tissue release & Breaking Adhesion

10. Passive Manual Treatments

11. Few Home exercise

12. Reference Millar, N.L., Meakins, A., Struyf, F.  et al.  Frozen shoulder.  Nat Rev Dis Primers  8, 59 (2022).https://doi.org/10.1038/s41572-022-00386-2 Accepted26 July 2022 Published08 September 2022 DOI: https://doi.org/10.1038/s41572-022-00386-2 Hand, C., Clipsham, K., Rees, J. L. & Carr, A. J. Long-term outcome of frozen shoulder.  J. Shoulder Elb. Surg.  17, 231–236 (2008). Key article looking at the longer term outcomes of frozen shoulder. Kim, D. H. et al. Is frozen shoulder completely resolved at 2 years after the onset of disease?  J. Orthop. Sci.  25, 224–228 (2020). https://www.arthritis-india.com/shoulder-exercises.html