title: Adhesive Capsulitis of the Shoulder. Is there Consensus Regarding the Treatment? A Comprehensive Review.
abstract: BACKGROUND
  Adhesive capsulitis of the shoulder (ACS) is a common self-limiting condition characterized by disabling pain and restricted movements. Its pathophysiology is poorly understood, clinically it is characterized by stages of pain and stiffness, and finally often patients never recover fully. However, there is no consensus about available methods of treatment for ACS. The aims of this paper are to discuss and develop issues regarding approaches to management in ACS in the stages of it.
  
  
  METHODS
  A review of the literature was performed and guidelines for the treatment of that clinical entity for doctors and health care professionals are provided.
  
  
  RESULTS
  Anti-inflammatory medications, steroid and/or hyaluronate injections and physiotherapy is the mainstay of conservative management either alone in the first stages or in combination with other treatment modalities in the later stages. Next line of treatment, involving minor to moderate intervention, includes suprascapular nerve block, distension arthrography and manipulation under anaesthesia. In order to avoid complications of "blind intervention", arthroscopic capsular release is gradually more commonly applied, and in recalcitrant severe cases open release is a useful option.
  
  
  CONCLUSIONS
  Various modalities of conservative management and gradually more surgical release are applied. However, often clinicians choose on personal experience and training rather than on published evidence.
authors.affiliation: Orthopaedics and Trauma Surgery 424 Military General Hospital, Thessaloniki, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Georgiannos
authors.affiliation: Orthopaedics and Trauma Surgery 424 Military General Hospital, Thessaloniki, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Markopoulos
authors.affiliation: Rheumatology 424 Military General Hospital, Thessaloniki, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Devetzi
authors.affiliation: Orthopaedics and Trauma Surgery 424 Military General Hospital, Thessaloniki, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Bisbinas
keywords: Adhesive capsulitis; Shoulder; Treatment