Re: Re: Re: Adhesive Capsulitis and MUA

Thursday, Dec 23, 2004

Re: Re: Re: Adhesive Capsulitis and MUA

Posted by Kent on 08/17/00 at 11:19 AM

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Gary,I too am pleased with my progress using physical therapy alone but concerned with future progress. My orthopedic surgeon has not mentioned manipulation under general anesthesia (MUA) as an option for my situation. I?m pleased because I have read (1995 Olgivie-Harris report) that MUA produced excellent results in only 7/18 patients vs. 15/20 with excellent results after arthroscopic capsular release outpatient surgery. I have also read that MUA is most effective when performed in the “frozen” stage of the condition, after the pain has started to spontaneously lessen, or at least 6 months after the onset of AC. I believe I?m still in the “freezing” stage based on my chronic and acute pain. I didn?t want to wait until I reach the “frozen” stage and I have read that some patients require follow-up MUA treatments, that the post-MUA pain is usually quite severe, and that up to several months of PT and home exercise are needed to maintain improved ROM and prevent recurrence in the same shoulder. And with MUA, there are risks of bone fracture or dislocation, aggravation to the partial tear of my rotator cuff muscle, or nerve palsy! Incidentally, my health insurance won?t cover chiropractic care beyond manipulation of the spine.

After reading widely about AC, I believe the shoulder pain will continue until the adhesions & scar tissue have been completely broken down and ROM restored by stretching or by surgery – all of which necessarily involve pain and ongoing aggravation & inflammation. I am hopeful that I will continue to respond to PT, but if my progress slows substantially I expect my orthopedist will recommend arthroscopy over MUA. Since my goal is to minimize the extent and duration of pain, and associated restless sleep, I will probably opt for arthroscopy since I understand the post-surgery pain and needed duration of follow-up PT is generally is greatly reduced. I look forward to the day that painful stretching exercises and pain-control medication are no longer needed.

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