Interventional microadhesiolysis: a new nonsurgical release technique for adhesive capsulitis of the shoulder.
BACKGROUND
A 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.


METHODS
Ten 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).


RESULTS
After 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.


CONCLUSIONS
Our findings suggest that interventional microadhesiolysis is effective for managing adhesive capsulitis of the shoulder.
Ahn
Kang
K
Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Ansan, Republic of Korea. kangahn2003@yahoo.com
Lee
Young-Jin
YJ
Kim
Eun-Ha
EH
Yang
Seung-Min
SM
Lim
Tae-Kyun
TK
Kim
Yong-Soo
YS
Jhun
Hyung-Joon
HJ
D000328:Adult; D002062:Bursitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D013582:Synovial Fluid; D016896:Treatment Outcome