You have really been through the ringer as they say. I hope you see some more improvement soon. It seems like you have had so many procedures that you should be as good as new now. I am glad to hear that you have priviate insurance as I know the wait can be ridiculous with the NHS over there. I am in the states where you better have health insurance or else!! And I do so I am fine. Actually most people do have health insurance here. But I do hope that you feel better soon. It is a shame that you are still having problems. It is a shame to hear that this all happened from an episode of bowling!!
The most common outcome following non-operative management of adhesive capsulitis with a stretching program is decreased range of motion compared to the contralateral side.
Adhesive capsulitis is defined as painful loss of motion of a shoulder without an underlying cause. While it is generally believed to be a self-limiting condition, numerous treatment methods have been suggested including benign neglect, steroid injections, physical therapy, manipulation, and arthroscopic or open capsular releases. Intra-articular steroid injections may provide an earlier return of shoulder range of motion, but have not shown a long-term difference. Non-operative management with a stretching program shows high rates of patient satisfaction, but it is commonly associated with decreased range of motion compared to the contralateral extremity.
Griggs et al. reviewed 75 patients with phase-2 adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 22 months, forward flexion increased by 19 degrees, but still remained 36 degrees less than the unaffected shoulder.
Shaffer et al. reviewed 62 patients with adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 7 years, 60% of patients had decreased range of motion in at least one plane when compared to a control-group of normal shoulders.
Answer 1: While continued pain is a frequent complication, it is usually much improved from the initial onset of the disease and does not affect quality of life.
Answer 3: Adhesive capsulitis is thought to have a low recurrence rate after it has resolved.
Answer 4: Surgical intervention following non-surgical management of adhesive capsulitis is rare since > 90% report satisfaction with non-operative treatment.
Answer 5: The association between rotator cuff arthropathy and adhesive capsulitis has not been studied.
The physical examination during the painful stage of adhesive capsulitis may reveal muscle spasm and diffuse tenderness about the glenohumeral joint and the deltoid muscle. An area of pinpoint tenderness is seldom found. With disease progression and in longstanding cases, disuse atrophy of the shoulder girdle may result. Passive and active range of motion in all planes of shoulder movement are lost ( Figure 5 ) . This global loss of motion is the primary factor distinguishing adhesive capsulitis from many of the conditions associated with secondary adhesive capsulitis.