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Personalized Multimodal Treatment for Adhesive Capsulitis: A Case Series on Regenerative Medicine and Noninvasive Therapies

Original Article | Vol 4 | Issue 2 |  July-December 2024 | page: 12-14 | Napoliane Costa Santos, André Vinicius Saueressig Kruel, Alex Pontes de Macedo, Fabio Ramos Costa, Luyddy Pires, Maria Laura Schiefelbein, Palmerindo Antônio Tavares de Mendonça Néto, Renata Takeyama de Oliveira, Daiane Agostini, Jose Fábio Lana

DOI: https://doi.org/10.13107/jrs.2024.v04.i02.145


Author: Napoliane Costa Santos [1], André Vinicius Saueressig Kruel [2], Alex Pontes de Macedo [1], Fabio Ramos Costa [3], Luyddy Pires [1], Maria Laura Schiefelbein [4], Palmerindo Antônio Tavares de Mendonça Néto [5], Renata Takeyama de Oliveira [1], Daiane Agostini [2], Jose Fábio Lana [1]

[1] Department of Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, SP, Brazil,
[2] Proregen Clínica Médica, Bento Gonçalves, Rio Grande do Sul, Brasil.
[3] TRATE – Traumatologia Esportiva, Salvador, Brazil,
[4] Departamento de Ortopedia, TRATE, Traumatologia Esportiva, Salvador, BA, Brazil, Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil,
[5] Instituto Regenera Dor, Juazeiro do Norte, Ceará, Brazil.

Address of Correspondence
Dr. André Kruel
Proregen Clínica Médica, Bento Gonçalves, Rio Grande do Sul, Brasil.
E-mail: kruel.andre@gmail.com


Abstract

Introduction: Adhesive capsulitis causes chronic shoulder pain and restricted range of motion (ROM). Conventional treatments often offer limited relief, prompting the need for innovative approaches, such as high-intensity pulsed electromagnetic field (PEMF) therapy, shockwave therapy, and orthobiologic injections.

Objective: To evaluate the efficacy of a multimodal approach combining shockwave therapy, high-intensity PEMF therapy, orthobiologic injections, and complementary therapies in improving pain and shoulder function in patients with adhesive capsulitis.

Methods: This retrospective case series included five patients treated in Indaiatuba, São Paulo, Brazil, between May 2023 and October 2024. Individualized multimodal protocols were performed. Pain and ROM were assessed pre- and post-treatment.

Discussion: All patients showed significant improvements in pain and ROM after treatment. High-intensity PEMF therapy, shockwave therapy, and orthobiologics enhanced tissue regeneration, supported by complementary therapies. Personalized protocols optimized outcomes, with synergistic effects observed between treatments.

Conclusion: A multimodal, personalized approach effectively reduced pain and improved function in adhesive capsulitis patients. This strategy shows promise, especially for those unresponsive to conventional treatments, warranting further research.

Keywords: Adhesive capsulitis, High intensity pulsed electromagnetic field therapy, Orthobiologics, Regenerative medicine, Shockwave therapy


References:

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How to Cite this article: Santos NC, Saueressig Kruel AV, de Macedo AP, Costa FR, Pires L, Schiefelbein ML, de Mendonça Néto PAT, de Oliveira RT, Agostini D, Fábio Lana J | Personalized Multimodal Treatment for Adhesive Capsulitis: A Case Series on Regenerative Medicine and Noninvasive Therapies. | Journal of Regenerative Science | July-December 2024; 4(2): 12-17.

 

 


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Extracorporeal Shockwave Therapy in the Treatment of Adhesive Capsulitis of the Shoulder: A Novel Approach-CapsuWave

Original Article | Vol 4 | Issue 2 |  July-December 2024 | page: 32-39 | Cláudio Lopes Simplício, Daiane Agostini, André V. S. Kruel, Guilherme Antônio Moreira de Barros, Izair Jefthe Rodrigues

DOI: https://doi.org/10.13107/jrs.2024.v04.i02.151


Author: Cláudio Lopes Simplício, Daiane Agostini, André V. S. Kruel, Guilherme Antônio Moreira de Barros, Izair Jefthe Rodrigues

[1] RJ Brazil Ortofisio Clinic-Instdor Clinic-São Paulo State, Universidade Estadual Paulista, Botucatu–São Paulo, Brazil,
[2] Proregen Clinic-Bento Gonçalves, State of Rio Grande do Sul, Brazil,
[3] Proregen Clinic, Bento Gonçalves-State of Rio Grande do Sul, Brazil,
[4] Antalgic Therapy and Palliative Care, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São Paulo, Brazil,
[5] Regen® Institute of Reparative Medicine, São Paulo, Brazil.

Address of Correspondence
Cláudio Lopes Simplício,
RJ Brazil Ortofisio Clinic-Instdor Clinic-São Paulo State, Universidade Estadual Paulista, Botucatu–São Paulo, Brazil.
E-mail: c.simplicio@unesp.br


Abstract

Adhesive capsulitis, commonly known as frozen shoulder, is a musculoskeletal condition characterized by intense pain and progressive limitation of mobility in the glenohumeral joint, often associated with diseases such as diabetes and autoimmune conditions. Its etiology remains incompletely understood but involves inflammatory and fibrotic factors that lead to adhesions of the articular capsule. The clinical presentation is divided into three phases: Inflammatory, frozen, and resolution, each varying in duration and symptom intensity. Extracorporeal shockwave therapy (ESWT) has emerged as a non-invasive treatment approach for this condition, showing positive results in improving range of motion and reducing pain. ESWT works by modulating the inflammatory response and promoting tissue regeneration, as evidenced by studies demonstrating its beneficial effects, especially when combined with other therapies. A detailed case study of a 58-year-old patient with a trauma history indicating adhesive capsulitis is presented, highlighting the symptoms and limitations encountered. Treatment included shockwave applications, following the CapsuWave technique, which optimizes treatment administration. Results suggest that ESWT offers a more accelerated functional recovery compared to other therapies, such as corticosteroid injections. Continued investigation into the pathophysiology of adhesive capsulitis and the efficacy of shockwave therapy is crucial for developing more effective treatment options. A multidisciplinary approach, integrating diverse areas of medicine, is essential for the proper management of this complex condition, aiming not only for pain reduction but also for improving the patients’ quality of life.
Keywords: Adhesive capsulitis, Shoulder pain, Extracorporeal shockwave therapy


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How to Cite this article: Simplício CL, Agostini D, Kruel AVS, de Barros GAM, Rodrigues IJ. Extracorporeal Shockwave Therapy in the Treatment of Adhesive Capsulitis of the Shoulder: A Novel Approach-CapsuWave. | Journal of Regenerative Science | July-December 2024; 4(2): 32-39.

 

 


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