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Konservative Therapie der „frozen shoulder“

  • A. Franz
  • M. Klose
  • K. BeitzelEmail author
Leitthema
  • 109 Downloads

Zusammenfassung

Die idiopathische Schultersteifigkeit (Frozen shoulder, FS) ist eine häufige Pathologie des Glenohumeralgelenks, die durch ein plötzlich einsetzendes Schmerzsyndrom und eine progressive Einschränkung der Beweglichkeit charakterisiert ist. Während die histologischen Veränderungen der FS neben einer synovialen Entzündung eine zunehmende Kapselfibrosierung zeigen, ist die zugrunde liegende Ursache der FS ist noch unbekannt. Die Behandlungsmöglichkeiten der FS sind vielfältig und beinhalten u. a. Medikamente, lokale Steroidinjektion, Physiotherapie, Hydrodistension, Manipulation unter Narkose sowie die arthroskopische und die offene Kapselfreilegung. Da die Erkrankung meist nach 2 bis 3 Jahren selbstlimitierend abklingt, kommen speziell konservative Therapiemaßnahmen klinisch häufig zum Einsatz. Allerdings gibt es in diesem Zusammenhang noch keinen wissenschaftlich basierten Konsens darüber, welche Therapiemaßnahmen in welcher Phase der Erkrankung am ehesten zur Symptomlinderung beitragen. Aus diesem Grund fokussiert der vorliegende Beitrag die Beschreibung der wissenschaftlich untersuchten konservativen Therapiemaßnahmen bei FS und deren zeitliche Einteilung in den klassisch-dreiphasigen Verlauf der Erkrankung.

Schlüsselwörter

Gelenkerkrankungen Idiopathische Schultersteifigkeit Schmerzen „Range of motion“ Physiotherapie 

Conservative treatment of frozen shoulder

Abstract

Idiopathic shoulder stiffness (i.e. frozen shoulder, FS) is a common pathology of the glenohumeral joint characterized by a sudden onset of pain syndrome and progressive restriction of the range of motion. While the histological changes of FS are accompanied by synovial inflammation and increasing capsular fibrosis, the underlying cause of FS is still unknown. The treatment options for FS are multifarious and include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic and open capsular release. As the disease is usually self-limiting and the symptoms resolve after 2–3 years, especially conservative treatment measures are often clinically applied; however, in this context there is still no scientifically based consensus on which treatment measures are most likely to contribute to symptom relief in which phase of the disease. For this reason, this article focuses on the description of the scientifically investigated conservative treatment methods in FS and their temporal classification into the classical three-phase course of the disease.

Keywords

Joint diseases Idiopathic shoulder stiffness Pain Range of motion Physiotherapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

A. Franz, M. Klose und K. Beitzel geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Literatur

  1. 1.
    Binder AI, Bulgen DY, Hazleman BL et al (1984) Frozen shoulder: a long-term prospective study. Ann Rheum Dis 43:361–364CrossRefGoogle Scholar
  2. 2.
    Bryant M, Gough A, Selfe J et al (2017) The effectiveness of ultrasound guided hydrodistension and physiotherapy in the treatment of frozen shoulder/adhesive capsulitis in primary care: a single centre service evaluation. Shoulder Elbow 9:292–298CrossRefGoogle Scholar
  3. 3.
    Buchbinder R, Green S, Forbes A et al (2004) Arthrographic joint distension with saline and steroid improves function and reduces pain in patients with painful stiff shoulder: results of a randomised, double blind, placebo controlled trial. Ann Rheum Dis 63:302–309CrossRefGoogle Scholar
  4. 4.
    Buchbinder R, Hoving JL, Green S et al (2004) Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis 63:1460–1469CrossRefGoogle Scholar
  5. 5.
    Buchbinder R, Youd JM, Green S et al (2007) Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: a randomized trial. Arthritis Rheum 57:1027–1037CrossRefGoogle Scholar
  6. 6.
    Buchbinder R, Green S, Youd JM (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev.  https://doi.org/10.1002/14651858.CD004016 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Burt MG, Roberts GW, Aguilar-Loza NR et al (2011) Continuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD. J Clin Endocrinol Metab 96:1789–1796CrossRefGoogle Scholar
  8. 8.
    Carette S, Moffet H, Tardif J et al (2003) Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum 48:829–838CrossRefGoogle Scholar
  9. 9.
    Codman EA (1934) The Shoulder. G. Miller & Company, BostonGoogle Scholar
  10. 10.
    Donatelli R, Ruivo RM, Thurner M et al (2014) New concepts in restoring shoulder elevation in a stiff and painful shoulder patient. Phys Ther Sport 15:3–14CrossRefGoogle Scholar
  11. 11.
    Dudkiewicz I, Oran A, Salai M et al (2004) Idiopathic adhesive capsulitis: long-term results of conservative treatment. Isr Med Assoc J 6:524–526PubMedGoogle Scholar
  12. 12.
    Famaey JP, Ginsberg F (1984) Treatment of periarthritis of the shoulder: a comparison of ibuprofen and diclofenac. J Int Med Res 12:238–243CrossRefGoogle Scholar
  13. 13.
    Favejee MM, Huisstede BM, Koes BW (2011) Frozen shoulder: the effectiveness of conservative and surgical interventions—systematic review. Br J Sports Med 45:49–56CrossRefGoogle Scholar
  14. 14.
    Guyver PM, Bruce DJ, Rees JL (2014) Frozen shoulder—a stiff problem that requires a flexible approach. Maturitas 78:11–16CrossRefGoogle Scholar
  15. 15.
    Itoi E, Arce G, Bain GI et al (2016) Shoulder stiffness: current concepts and concerns. Arthroscopy 32:1402–1414CrossRefGoogle Scholar
  16. 16.
    De Jong BA, Dahmen R, Hogeweg JA et al (1998) Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens. Clin Rehabil 12:211–215CrossRefGoogle Scholar
  17. 17.
    Jurgel J, Rannama L, Gapeyeva H et al (2005) Shoulder function in patients with frozen shoulder before and after 4‑week rehabilitation. Medicina (Kaunas) 41:30–38Google Scholar
  18. 18.
    Khan AA, Mowla A, Shakoor MA et al (2005) Arthrographic distension of the shoulder joint in the management of frozen shoulder. Mymensingh Med J 14:67–70PubMedGoogle Scholar
  19. 19.
    Kraal T, Visser C, Sierevelt I et al (2016) How to treat a frozen shoulder? A survey among shoulder specialists in the Netherlands and Belgium. Acta Orthop Belg 82:78–84PubMedGoogle Scholar
  20. 20.
    Kraal T, Sierevelt I, Van Deurzen D et al (2018) Corticosteroid injection alone vs additional physiotherapy treatment in early stage frozen shoulders. World J Orthop 9:165–172CrossRefGoogle Scholar
  21. 21.
    Lin HC, Li JS, Lo SF et al (2009) Isokinetic characteristics of shoulder rotators in patients with adhesive capsulitis. J Rehabil Med 41:563–568CrossRefGoogle Scholar
  22. 22.
    Lin JJ, Wu YT, Wang SF et al (2005) Trapezius muscle imbalance in individuals suffering from frozen shoulder syndrome. Clin Rheumatol 24:569–575CrossRefGoogle Scholar
  23. 23.
    Longo UG, Ciuffreda M, Locher J et al (2018) The effectiveness of conservative and surgical treatment for shoulder stiffness: a systematic review of current literature. Br Med Bull 127:111–143CrossRefGoogle Scholar
  24. 24.
    Lorbach O, Anagnostakos K, Scherf C et al (2010) Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg 19:172–179CrossRefGoogle Scholar
  25. 25.
    Maitland GD (1993) Treatment of the glenohumeral joint by passive movement. Physiotherapy 1983:6836050Google Scholar
  26. 26.
    Ohta S, Komai O, Hanakawa H (2014) Comparative study of the clinical efficacy of the selective cyclooxygenase‑2 inhibitor celecoxib compared with loxoprofen in patients with frozen shoulder. Mod Rheumatol 24:144–149CrossRefGoogle Scholar
  27. 27.
    Page MJ, Green S, Kramer S et al (2014) Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev.  https://doi.org/10.1002/14651858.CD011275 CrossRefPubMedGoogle Scholar
  28. 28.
    Van Raalte DH, Brands M, Van Der Zijl NJ et al (2011) Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial. Diabetologia 54:2103–2112CrossRefGoogle Scholar
  29. 29.
    Reeves B (1975) The natural history of the frozen shoulder syndrome. Scand J Rheumatol 4:193–196CrossRefGoogle Scholar
  30. 30.
    Robinson PM, Norris J, Roberts CP (2017) Randomized controlled trial of supervised physiotherapy versus a home exercise program after hydrodilatation for the management of primary frozen shoulder. J Shoulder Elbow Surg 26:757–765CrossRefGoogle Scholar
  31. 31.
    Ryans I, Montgomery A, Galway R et al (2005) A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford) 44:529–535CrossRefGoogle Scholar
  32. 32.
    Sharma SP, Baerheim A, Moe-Nilssen R et al (2016) Adhesive capsulitis of the shoulder, treatment with corticosteroid, corticosteroid with distension or treatment-as-usual; a randomised controlled trial in primary care. BMC Musculoskelet Disord 17:232CrossRefGoogle Scholar
  33. 33.
    Sun Y, Lu S, Zhang P et al (2016) Steroid Injection Versus Physiotherapy for Patients With Adhesive Capsulitis of the Shoulder: A PRIMSA Systematic Review and Meta-Analysis of Randomized Controlled Trials. Med (baltimore) 95:e3469CrossRefGoogle Scholar
  34. 34.
    Tamai K, Akutsu M, Yano Y (2014) Primary frozen shoulder: brief review of pathology and imaging abnormalities. J Orthop Sci 19:1–5CrossRefGoogle Scholar
  35. 35.
    Tveita EK, Tariq R, Sesseng S et al (2008) Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord 9:53CrossRefGoogle Scholar
  36. 36.
    Vermeulen HM, Rozing PM, Obermann WR et al (2006) Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther 86:355–368PubMedGoogle Scholar
  37. 37.
    Widiastuti-Samekto M, Sianturi GP (2004) Frozen shoulder syndrome: comparison of oral route corticosteroid and intra-articular corticosteroid injection. Med J Malaysia 59:312–316PubMedGoogle Scholar
  38. 38.
    World Health Organisation (WHO) (1996) Cancer Pain Relief (2nd edn). WHO: GenevaGoogle Scholar
  39. 39.
    Wu WT, Chang KV, Han DS et al (2017) Effectiveness of glenohumeral joint dilatation for treatment of frozen shoulder: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 7:10507CrossRefGoogle Scholar
  40. 40.
    Yang JL, Chang CW, Chen SY et al (2007) Mobilization techniques in subjects with frozen shoulder syndrome: randomized multiple-treatment trial. Phys Ther 87:1307–1315CrossRefGoogle Scholar
  41. 41.
    Yoon JP, Chung SW, Kim JE et al (2016) Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial. J Shoulder Elbow Surg 25:376–383CrossRefGoogle Scholar
  42. 42.
    Zheng XQ, Li K, Wei YD et al. (2014) Nonsteroidal anti-inflammatory drugs versus corticosteroid for treatment of shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil 95:1824-1831CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.ATOS Orthoparc KlinikKölnDeutschland
  2. 2.Abteilung für SportorthopädieTechnische Universität MünchenMünchenDeutschland

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