Adhesive Capsulitis Case Study

DOI: 5/8/2016. Patient is a 48-year old male maintenance operator who sustained a strained shoulder when he was throwing waste metal into a bin.The patient was subsequently diagnosed with left shoulder impingement syndrome with massive tear of the supraspinatus and infraspinatus tendons. MRI report dated 5/28/16 revealed suboptimal examination; massive full-thickness rotator cuff tear involving the entire supraspinatus and infraspinatus tendons with severe medial retraction beyond the level of the glenoid measuring approximately 6.2 cm. Severe fatty atrophy and loss of muscle bulk in the supraspinatus and infraspinatus muscles; large glenohumeral joint effusion with fluid in the subacromial/subdeltoid bursa and subcoracoid bursa; mild to moderate degenerative changes of the glenohumeral joint; severe acromioclavicular joint arthritis with

• Doing strength and range-of-motion exercises (physical therapy) as told by your health care provider.

ROM, pain level and strength were all improved on re-evaluation. Short-term and long-term goals were achieved. Treatment plan was to educate HEP, E-stim-unattended, Joint/Soft tissue mobilization, manual therapy, MHP/CP, neuromuscular re-education, Therapeutic exercise and strengthening-increase ROM, and Ultrasound.

Per the PT note dated 12/27/16, patient states doing home exercise program (HEP) 3 times daily, though she still has difficulty with range of motion (ROM) of the left upper extremity. Patient has attended 4/12 sessions.

The difficult combination of adhesive capsulitis and a torn rotator cuff in a patient with blood sugars that however around the 200s, was discussed. He understands that he is an increased risk of multiple complications and his therapy will likely take longer due to the inevitable stiffness that will occur. He would like to proceed.

The patient will continue physical therapy 1 day per week for 8 weeks where he will receive moist heat, cold packs, electrical stimulation, massage therapy, ultrasound to the right shoulder by followed by gentle range of motion and strengthening exercises with the goals of reducing pain, improving strength, improving range of motion, improving overall function, and teaching home exercise program.

He still does have significant amount of residual back pain. Also, he does get still intermittent pain and numbness in the legs, left side worse than the right side. He also gets bilateral knee pain. He continues to have some bladder incontinence episode urgency. He does feel depressed as well. Treatments to date include anti-inflammatory medications, physical therapy, epidural injection performed in May 2015, spinal surgery in 2011, L4-L5 laminotomy with good improvement, and left L5-S1 laminotomy on 4/20/16 with improvement postoperative. Physical examination revealed that the patient has been able to discontinue the use of cane. There is pain to palpation over the L5-S1 area. Range of motion is limited. The patient has flexion of 60% of normal and extension of 40% of normal. Motor strength is 5-/5 in the left lower extremity, especially in the gastrocsoleus and extensor hallucis longus. Sensation is slightly diminished in the L5 distribution bilaterally, left worse than the right. Deep tendon reflexes is 2+ at the bilateral knee and 1 + at the bilateral ankle. Plan notes physical therapy of 2 x/ week to strengthen muscles, stabilize the spine and reduce pain; Flector patch 1.3% to be applied one patch to the back every 12 hours as necessary for

In order to establish a treatment, plan it is important to set goals for this patient. In general goals for RA include early recognition and diagnosis, referral to a rheumatologist, and tight control and low disease activity (Cohen & Cannella, 2017). There are also scales that need to be completed by the NP and patient to determine how the treatment is working for a patient. When setting goals, it is important to determine a successful way to evaluate this patients' pain. In the older population it is common for pain to be under treated and part of the cause of this is because the assessment for pain is not matching the patients' needs. Once a successful evaluation has been chosen for this pain it would be important to use this same

The patient in question for this case study is a forty-three year old female who works as an administrator, and plays badminton twice a week and has been suffering with right shoulder pain and stiffness. Assessment confirms a diagnosis of right adhesive capsulitis.

It also could be tender when someone touches it. There are some ways to prevent this disease from your body, accrue the proper body mass, don’t weigh more or less than you should. Also always stretch before any activity, warm up with and god hot shower. Prevent any extension of the leg, such as extending the knee in the sitting position against resistance. Treatment for this disease consistence of anything that is recommended by your doctor, ice, stretching exercises, strengthening exercise or even pain medications. Activities such as kneeling, jumping, squatting, stair climbing and running should be avoided while of in the process of heling. Ice should defiantly be applied soon as you figure you’ve had it for at least 15-20 min to the effected knew every2-3 hours as needed to help reduce inflammation and pain. And heat packs can be used for when you’re wanting to do actives. Your doctor can set up exercises for you that you could do at home, set just for you, its best that you do them twice a day and don’t anyone use them, because what could be your healing process can possibly hurt the person that’s not in

It is characterized by a spontaneous onset of pain with gradual, progressive loss of glenohumeral joint motion which can lead to gross loss of shoulder function. The conditions usually starts with one shoulder and commonly affects the contralateral side years after the onset of symptoms in the first shoulder but it does not affect the same shoulder twice (Lundberg J. 1969 and

Patient unable to walk heel to toe, perform the Romberg test, stand on one foot, or perform a shallow knee bend without risk of falling. The patient complains of lower back, hip, and knee pain. . Assessed patient’s pain at this time. Patient states that, “the pain is felt in her lower back, hips, and knees constantly and relieved with ibuprofen” she rated the pain a 4 on a scale from 0 to 10. Patient stated, “lower back always aches.” Described the pain as constant and dull. Affects her activities of daily living because she “isn’t able to cook, clean, or exercise.” In a supine position the patient, with help, was able to extend legs upwards about 40 degree and flex hips with limited range of motion. Patient was able to resist with light resistance when pressure was applied to the legs anteriorly and posteriorly. Sitting back in the patient’s chair, the patient was able to bend at the hip. No pain or tenderness felt when palpating the spinous process. The patient was able to actively flex and extend the ankle joints with limited range of motion and some resistance with support under the lower leg. The patient was able to flex and extend the feet with limited range of motion and some resistance. No pain or crepitus with flexion and extension of the feet and ankles. Inspected the patient’s skin of the anterior and posterior legs, ankles, and feet. The skin of the upper legs were dry, with

A study done by Harvard says the best way to treat PAD is to “get exercise, don’t smoke, manage chronic conditions,and take medication to prevent blood clotting.” Harvard Health Publishing (2012). Many researchers have discovered the best way to comply with or reverse the symptoms of PAD is to simply change parts of your lifestyle; although, some changes are easier said than done. Medical professionals have been recommending these life altering treatments for years. They advise patients who are fighting against PAD to maintain their new healthy habits in an effort to help prevent recurring symptoms of the disease. Their has recently been a clinical trial for patients with worsening symptoms of PAD. According to PAD Study (2018) “The investigational treatment includes removal of some bone marrow from the hips, which is then processed in the investigational device to separate the stem cells for delivery by injection to multiple sites in the affected leg. The goal of the study is to evaluate the efficacy of the MarrowStim™ PAD Kit to prevent or delay major amputation and/or death by restoring blood flow and renewing circulation to the leg and foot.” The side effects of this new treatment include multiple risk factors: minimal discomfort, bruising, anemia, minor complications from bone marrow extraction, hip

For the most part there is no definite treatment for this disease. Large amounts of activity, cold weather, or pressure on the muscles can trigger the rippling. Each treatment is determined

The stiffness is the most difficult sensation to bear. The swollen and adhering connecting tissues do not allow the joint to function, as evidenced by capsular biopsy of the dense hypercellular collagenous tissue, especially at the front of the capsule. (Xiangnan Yuan, 2017). The chronic stage, there are little or no pain as inflammation has taken place but it remains the elasticity of the joint. The scar tissue and adhesions are fully developed and cover the structure of the joint that shows by