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Z Orthop Unfall 2019; 157(06): 668-675
DOI: 10.1055/a-0853-2128
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Shoulder Stiffness – How to Treat?

Article in several languages: English | deutsch
Davide Cucchi
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Sebastian Gottfried Walter
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Dieter Christian Wirtz
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Max Julian Friedrich
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
› Author Affiliations
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Publication History

Publication Date:
10 July 2019 (online)

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Abstract

Shoulder stiffness is a condition of restricted glenohumeral range of motion, which can arise spontaneously or as consequence of a known cause, including surgical procedures on the shoulder. Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. The aim of this review was to summarize the current concepts on conservative and operative treatment of shoulder stiffness and discuss the results of the available studies with a high level of evidence, which should be considered to guide clinical practice. Treatment of shoulder stiffness should be tailored to the patientʼs clinical situation and the stage of its shoulder pathology and should aim at pain reduction, restoration of range of motion, functional regain and shortening of symptoms duration. When possible, known risk factors for primary shoulder stiffness and causes of secondary shoulder stiffness should be addressed to avoid relapse. Conservative therapy is the mainstay of treatment for shoulder stiffness and should include a multimodal and activity-oriented program. Intra-articular injection of a low dose of corticosteroid is safe and effective, provides immediate benefits, and is recommended in combination to an appropriate rehabilitation protocol. In conservative refractory cases, arthrolysis and capsular release can be performed with an arthroscopic approach.

Key words

shoulder stiffness - adhesive capsulitis - frozen shoulder - treatment algorithm - results
 

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