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Adhesive Capsulitis, a Half Century Later
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Posted on: 11/11/2003
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The year is 1945. Harry S. Truman is sworn in as the United States' 33rd president. World War II is coming to an end with the defeat of Germany and Japan. The Alaskan Highway is now open, and Joe DiMaggio is getting out of the Army and joining the New York Yankees.
Many people know about these events, even young adults who weren't born until much later. But there's one thing you probably don't know about 1945. Dr. J. S. Neviaser came up with the term adhesive capsulitis to describe a painful shoulder condition.
In the normal shoulder, a thick joint capsule wraps around the head of the humerus (upper arm). With adhesive capsulitis, the capsule tightens up. Synovial fluid in the joint dries up, and the joint becomes inflamed. It's a well-known diagnosis today, and a common shoulder problem in the general adult population.
Even after more than 50 years, there isn't a single best treatment for the problem. Doctors at the Hospital for Special Surgery (Cornell University) in New York report on the results of one treatment. It's called capsular
distention.
In this procedure, a liquid salt solution called saline is squirted into the shoulder joint capsule. The saline stretches the capsule to the breaking point. When no further resistance is felt, the capsule is ruptured. A video X-ray called fluoroscopy helps guide the doctor. A dye injected into the joint shows leakage outside the capsule as another sign of rupture.
The authors say this method works best for adhesive capsulitis at a certain stage. It improves range of motion and decreases pain for patients with moderate to severe pain and loss of motion (stage II). They suggest using capsular distention in stage II adhesive capsulitis for the best results.
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References:
Vijay B. Vad, MD, et al. The Role of Capsular Distention in Adhesive Capsulitis. In Archives of Physical Medicine and Rehabilitation. September 2003. Vol. 84. No. 9. Pp. 1290-1292.
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