Monday, May 30, 2011

Adhesive Capsule - Treatment

Numerous studies have reported an inflammatory component adhesive capsulitei. Therefore indicate that use of NSAIDs in the initial treatment phase freezing. By reducing inflammation, pain and physical therapy patient can tolerate. Depending on the severity of symptoms may indicate three weeks of oral corticosteroids. Due to the severe effects of these drugs come true patient should ask your medical history. Diabetes mellitus is not an absolute contraindication to corticosteroids, but because their hyperglycaemic effects patient requires careful monitoring.Corticosteroids are indicated for severe freezing of the shoulder for a long time or if it cause significant pain.
Intra-articular injections of sodium hyaluronate:Sodium hyaluronate has a metabolic effect on articular cartilage tissue and the fluid sinoaviale. In some studies the agent was more effective than corticosteroid injections or physical therapy in improving fucntiei. Although studies are still needed, the injection of sodium hyaluronate is an alternative treatment for frozen shoulder, especially in patients in whom corticosteroids are contraindicated.
Administration of drugs:Pharmacological intervention aims pain in the first two stages of the disease, because no official pathological process affects. They do not affect disease duration or severity of glenohumeral joint contracture. Patients can use painkillers such as acetaminophen.During the months of painful conditions, when the rest and night pain are disturbing indicate the use of narcotics. Enter calcitonin or oxycodone.
Artrografia glenohumeral of distension:Some studies show the benefits of artrografiei glenohumeral intra-articular corticosteroid injections, to improve movement, reduce the use of analgesics.
Nerve blocks:Suprascapular nerve block is a simple procedure is introduced in the bupivacaine to infiltrate the supraspinatus fossa floor fascial content and produce indirect suprascapular nerve block.
Surgical therapy:A subset of patients who did not respond to aggressive therapy nonchirurgicala recommended for surgery. They have a capsule recalcitrant. Different techniques such as new or improved through access arthroscopic capsular release of the capsule and glenohumeral ligament earlier seem to be promising therapeutic coracohumeral. Some doctors recommend early surgery in patients with frozen shoulder because of the high risk of permanent contracture of the glenohumeral joint. However, this option remains controversial because patients with diabetes and recurrent contracture and postoperative rehabilitation phase due to high complication rate.

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