Peter G.D. Rose, Navid Prasad, Rob Lloyd-Smith, Nick Rose, Michael Koehle, Donald McKenzie
Adhesive capsulitis or “frozen shoulder” is a shoulder joint condition defined by pain with decreased active and passive range of motion. The etiology is poorly understood, but the pathological process involves a local inflammatory state, followed by fibrosis or contracture. The condition is often a self-limiting process that resolves within 18-24 months with benign neglect or conservative treatment. Patients failing to improve may require more invasive surgical procedures. The goal of conservative treatment is to reduce pain and improve function; usually this consists of analgesics, non-steroidal anti-inflammatory drugs and physical therapy. Invasive procedures used in non-responsive cases carry significant risks, including humoral fracture, infection, and general anesthesia complications. Suprascapular nerve block is a new treatment where the nerve innervating the shoulder joint is blocked with local anesthetic. Currently, this procedure is not the standard secondary treatment for adhesive capsulitis, but in the future may prove to be an effective way to avoid the risks of more invasive procedures in non-responsive patients. In this case study we describe the clinical presentation, diagnosis, and treatment of adhesive capsulitis in a 52 year-old female who received suprascapular nerve block treatment after failure of conservative primary treatment.
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Rose PGD, Prasad N, Lloyd-Smith R, Rose N, Koehle M, McKenzie D. Effective Reduction of Adhesive Capsulitis Pain With a Suprascapular Nerve Block Given in a Primary Care Clinic. UBCMJ. 2009 1(1):30-33.