Abstract
BackgroundA nonsurgical intervention, interventional microadhesiolysis, was developed to release adhesions in joints and soft tissues. This paper introduces the procedure and evaluates the efficacy of the intervention for adhesive capsulitis of the shoulder.MethodsTen patients (five men and five women) with primary adhesive capsulitis of the shoulder were treated at a chronic pain management center in Korea. Three specially made needles are used in interventional microadhesiolysis: the Round, Flexed Round, and Ahn's needles. A Round Needle is inserted on the skin over middle of supraspinatus and advanced under the acromion and acromioclavicular joint (subacromial release). A Flexed Round Needle is inserted two-fingers caudal to the inferior border of the scapular spine and advanced over the capsule sliding on the surface of infraspinatus muscle-tendon fascia. The capsule is released while an assistant simultaneously passively abducts the shoulder to full abduction (posteroinferior capsule release). An Ahn's Needle is inserted on the skin over the lesser tubercle and advanced under the coracoid process sliding on the surface of the subscapularis muscle (subcoracoid release).ResultsAfter the patients underwent interventional microadhesiolysis, the self-rated pain score or severity declined significantly (p < .01), the shoulder range of motion increased significantly (p < .01), and joint effusion in the affected shoulder decreased or disappeared in nine of ten patients on magnetic resonance imaging compared to their initial status.ConclusionOur findings suggest that interventional microadhesiolysis is effective for managing adhesive capsulitis of the shoulder.
Highlights
A nonsurgical intervention, interventional microadhesiolysis, was developed to release adhesions in joints and soft tissues
Evidence exists that the pathological changes underlying adhesive capsulitis involve synovial inflammation with subsequent reactive capsular fibrosis, which is the ultimate course of adhesive capsulitis irrespective of the underlying cause [9]
After the patients underwent interventional microadhesiolysis, their self-rated pain score or severity declined significantly compared to their initial status (p < .01)
Summary
A nonsurgical intervention, interventional microadhesiolysis, was developed to release adhesions in joints and soft tissues. Adhesive capsulitis of the shoulder is characterized by pain in the shoulder and limitation of glenohumeral movement It tends to occur in patients older than 40 years of age and most commonly in females in their 50s. The limitations of these procedures should be considered: readhesion can result from bleeding or oozing during or after the procedure; intervention-related risks, such as bleeding, infection, and pain after procedures, can occur [10]. Despite these limitations, randomized controlled trials have provided little evidence to support or dispute the efficacy of these interventions [11]
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