A new approach for the management of frozen shoulder associated with reflex sympothetic dystrophy is presented. A suprascapular nerve block was performed by needle insertion behind the lateral end of the clavicle at its junction with the insertion of the trapezius muscle; the needle was directed downwards and backwards. The suprascapular nerve was identified response to nerve stimulation. Three ml of 0.25% bupivacaine with 1:200 000 adrenaline was injected.
Ozone therapy in treatment of frozen shoulder
- Shoulder Joint
- the glenohumeral,
- sternoclavicular and
- scapulothoracic joints,
- that act synergistically.
- Frozen shoulder
|The shoulder joint has a great range of motion with four separate articulations:
Painful restriction of shoulder movement of soft tissue origin.
These include frozen shoulder , periarthritis or pericapsulitis of the shoulder , adhesive capsulitis and adherent or obliterative bursitis.
- Common in the fifth and sixth decades
- Slightly more common among women
- 2-5 percent of general population
- 10-20 percent of people with diabetes
- Diabetes mellitus
- Cardiac disease or surgery.
- Pulmonary tuberculosis.
- Pulmonary carcinoma.
- Myocardial infarction.
- Cerebrovascular accident.
- Shoulder trauma.
A diffuse inflammatory synovitis leads to a loss of the normal axillary pouch and joint volume which leads to a significant loss of motion.
Capsular contracture is a result from adhesion of capsular surfaces or fibroblastic proliferation.
OZONE ACTS ON FIBROSIS AND THICKENED SYNOVIUM.
- Ozone – steroid mixture
Once the initial pain of frozen shoulder lessens, certain exercises, as shown by the physiotherapist, should be done to improve shoulder mobility.