Challenge of the Week / Shoulder & Elbow / 12.18.2020

A 55-year-old female patient presents with 3 months of shoulder pain. She has limited active and passive range of motion, difficulty with overhead activities, and trouble sleeping on the affected side. Her medical history includes obesity and type- 2 diabetes mellitus. In addition to physical therapy and oral nonsteroidal anti-inflammatory drugs (NSAIDs), what other treatment modality can be used as a first-line treatment for this process?
    • Corticosteroid injection
    • Steroid injections have been shown to improve pain and range of motion in the short term, without being able to shorten the course of adhesive capsulitis
    • Manipulation under anesthesia
    • This is not typically first-line treatment, but it is an option for patients who have failed at least 3 months of nonoperative treatments
    • Arthroscopic capsular release
    • This is not typically first-line treatment, but it is reserved for patients who have failed at least 3 months of-nonoperative treatments
    • Continuous passive motion (CPM) therapy
    • On its own, CPM has not been shown to be effective in improving symptoms of adhesive capsulitis, but it can be used as an adjunct after manipulation under anesthesia or capsular release.

     

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