Treatment of capsulitis with drugs and folk remedies

The method of treating inflammation of the synovial bursa and joint capsule depends on the stage of the disease. It takes into account the fact that the pathology tends to resolve on its own. Treatment is carried out in an outpatient setting.

1. Pain phase

Treatment is aimed at reducing pain. Limiting the load on the joint is indicated. In case of severe pain, the patient is recommended complete rest, but prolonged immobilization increases functional insufficiency. NSAIDs and intra-articular administration of glucocorticosteroids are used to relieve pain.

2. Stiffness phase

At this stage, drug therapy is not carried out. Treatment is aimed at increasing motor activity in the affected area. Physiotherapy and other rehabilitation methods are used for this purpose.

3. Adhesive stage

At this stage, drug therapy is ineffective, so surgical intervention is indicated to restore joint mobility. The scope of the operation depends on the degenerative changes in the joint tissues and the individual characteristics of the patient's body.

Medicines used in the treatment of capsulitis

The main groups of drugs for the treatment of capsulitis:

Painkillers – used to reduce pain. Patients are prescribed both tablet forms and injections to block nerve endings.

1. Ketanov

A medicinal product with analgesic properties and the active component is ketorolac tromethamine. Inhibits prostaglandin synthesis, has anti-inflammatory and pronounced analgesic effects. Does not inhibit the respiratory center and does not cause an increase in RSO. Does not affect the psychomotor functions of the central nervous system.

• Indications for use: injection solution and tablets are prescribed to relieve severe and moderate pain of various localizations. The drug is effective in the postoperative period, for acute pain due to sprains, fractures, dislocations, and also for toothache.
• Method of administration: intramuscularly 10 mg with further dosage of 10-30 mg every 4-6 hours. The maximum daily dose is 90 mg, and the duration of treatment is 48 hours. Tablets are taken orally 1 capsule every 4-6 hours. The duration of treatment should not exceed 7 days.
• Side effects: nausea, abdominal pain, increased drowsiness and weakness, headaches, diarrhea, dizziness, irritability, tachycardia. Local pain is possible with intramuscular administration.
• Contraindications: patient age under 16 years, bronchial asthma, gastric ulcer and duodenal ulcer, renal failure, intolerance to active components, pregnancy and lactation.
• Overdose: difficulty breathing, pale skin, vomiting, increased weakness. Treatment is symptomatic, gastric lavage is recommended.

The drug is available in the form of ampoules with 10 pieces per package, and also in tablet form with 10 capsules per pack.

2. Diclofenac

Analgesic, anti-inflammatory and antipyretic agent. Contains the active substance - sodium diclofenac. In rheumatic diseases, it relieves pain, reduces stiffness and swelling of joints, increases the range of motion in the affected area.

• Indications for use: inflammatory diseases of joints and soft tissues, injuries of the musculoskeletal system, acute attack of gout, neuralgia, neuritis, lumbago, bursitis, postoperative pain syndrome.
• Method of administration: intramuscularly 75 mg 2 times a day, course of treatment 4-5 days. The dosage of tablets is selected individually for each patient.
• Side effects: dyspeptic phenomena, erosive and ulcerative lesions, gastrointestinal bleeding, allergic reactions, headaches and dizziness, increased drowsiness and irritability. Overdose is manifested by an increase in the above reactions. Treatment is symptomatic.
• Contraindications: gastric ulcer and duodenal ulcer, kidney and liver disease, last trimester of pregnancy and lactation, bronchial asthma, intolerance to the components of the drug, allergic reactions, patients under 6 years of age.

Diclofenac is available as an injection solution and as tablets for oral use.

3. Denebol

A highly selective cyclooxygenase II inhibitor from the NSAID group. It has a pronounced analgesic, moderate anti-inflammatory, anti-edematous and antipyretic effect.

• Indications for use: diseases of the musculoskeletal system, acute and chronic periarthritis, rheumatoid arthritis, bursitis, tendonitis, osteoarthritis, injuries of tendons, muscles and ligaments. The drug is effective in combat syndromes of various origins, as well as symptomatic therapy for infectious and inflammatory diseases of the urinary system, in ophthalmology, gynecology, and damage to the respiratory system.
• Method of administration: injections are administered intramuscularly once a day at intervals of 24 hours, intravenous administration is contraindicated. The recommended dosage is 50 mg per day. Tablets are taken 25 mg once a day. The course of treatment is from 4 to 6 weeks.
• Side effects: confusion, drowsiness, headaches and dizziness, nausea, vomiting, congestive heart failure, decreased renal function, allergic reactions, swelling of the lower extremities. Overdose has similar symptoms, treatment is symptomatic.
• Contraindications: intolerance to the components of the drug, pediatric patients, oncological diseases. Injections are prohibited in case of heart attacks and strokes in the anamnesis, progressive form of atherosclerosis, arterial hypertension. The drug is not used during pregnancy and lactation.

Denebol is available as an injection solution and as tablets, rectal suppositories and gel for external use.

NSAIDs – non-steroidal anti-inflammatory drugs reduce inflammation and swelling. Reduce the severity of pain and stimulate recovery processes.

1. Nise

Analgesic, anti-inflammatory and antipyretic agent. Suppresses the formation of prostaglandin in the inflammation focus, inhibits COX2. Reduces joint pain at rest during movement, relieves swelling and stiffness.

• Indications for use: post-traumatic pain syndrome, osteoarthrosis, osteoarthritis, bursitis, rheumatism, muscle pain, myalgia, neuralgia, spinal pain, infectious diseases. The preparation in the form of a gel is used for degenerative and inflammatory lesions of the musculoskeletal system, tendons and ligaments.
• The method of administration and dosage depend on the form of the drug. Tablets are taken orally at 100 mg per day, the maximum daily dosage is 400 mg. The gel is applied to cleansed skin, rubbing into a thin layer 3-4 times a day. The course of treatment is 10-14 days.
• Side effects: headaches, increased sleepiness, nausea and vomiting, gastralgia, gastrointestinal pain, ulceration of the gastrointestinal mucosa, fluid retention in the body, anemia and leukopenia, increased activity of liver enzymes. The gel can cause skin allergic reactions: itching, urticaria, peeling of the skin.
• Contraindications: peptic ulcer of the gastrointestinal tract in the acute stage, hypersensitivity to the components of the drug, liver and kidney failure. Pregnancy and lactation, childhood of patients.
• Overdose: increased severity of adverse reactions. Treatment consists of symptomatic therapy.

Nise is available in the form of tablets of 100 and 50 mg of the active ingredient, as a suspension for oral administration, tablets and gel for external use.

2. Dicloberl

Non-steroidal anti-inflammatory drug with the active component diclofenac sodium. Has a pronounced anti-inflammatory, analgesic and anti-edematous effect.

• Indications for use: various rheumatic diseases, gout, degenerative joint diseases, painful sensations from injuries to soft tissues or the musculoskeletal system, ankylosing spondylitis, myalgia, primary dysmenorrhea.
• Method of administration: the drug is administered intramuscularly into the gluteal muscle at a dosage of 75 mg, the maximum daily dose is 150 mg. For long-term treatment, oral and rectal forms of the drug are used. Tablets are taken at 50 mg 2-3 times a day. The duration of therapy is determined by the attending physician individually for each patient.
• Side effects: dyspepsia, glossitis, gastrointestinal bleeding, vomiting and diarrhea with blood impurities. Headaches and dizziness, insomnia, increased fatigue and excitability, visual and taste disturbances, increased heart rate and skin allergic reactions are also possible.
• Contraindications: intolerance to the components of the drug, gastric ulcer or duodenal ulcer, peptic ulcer, hematopoiesis disorders, bronchial asthma, childhood, pregnancy and lactation.
• Overdose: headaches and dizziness, disorientation, convulsions, nausea and vomiting, abdominal pain, gastrointestinal bleeding. Treatment is symptomatic, gastric lavage is effective.

Dicloberl is available as an injection solution, enteric-coated tablets, prolonged-release capsules and suppositories.

3. Aertal

A drug from the NSAID group with the active component - aceclofenac. It has anti-inflammatory, antipyretic and analgesic effects. Reduces morning stiffness and swelling of joints in rheumatic diseases.

• Indications for use: elimination of pain syndrome and reduction of the severity of the inflammatory process in capsulitis, lumbago, rheumatic lesions of soft tissues. Also used to relieve toothache.
• Method of administration: take 1 tablet twice a day. The duration of treatment is determined by the attending physician, for each patient individually.
• Side effects: nausea, vomiting, bowel and digestive disorders, increased activity of liver enzymes, pain in the epigastric region, hepatitis, gastrointestinal bleeding. Headaches, taste disturbances, urinary system disorders, skin allergic reactions are also possible.
• Contraindications: hypersensitivity to active components and other NSAIDs, ulcerative lesions of the gastrointestinal mucosa, impaired renal and hepatic function, disorders of the hematopoietic system. Not used to treat pregnant women and children, as well as during lactation.
• Overdose: headaches and dizziness, abdominal pain, nausea and vomiting, convulsions. There is no specific antidote, gastric lavage and enterosorbents are indicated.

Aertal is available in tablet form.

In addition to the above NSAIDs, Ketorol, Aceclofenac, Indomethacin and other drugs can be used to treat periarthritis.

Glucocorticoids and glucocorticosteroids are hormonal drugs used for severe pain symptoms and the ineffectiveness of NSAIDs.

1. Prednisolone

A synthetic analogue of the hormones cortisone and hydrocortisone, but unlike natural substances, it does not cause fluid retention in the body. It has anti-inflammatory, anti-shock, antitoxic and anti-exudative properties.

• Indications for use: diffuse lesions of connective tissue and blood vessels, rheumatism, joint inflammation, bronchial asthma, leukemia, infectious mononucleosis, neurodermatitis and other allergic diseases.
• The method of administration and dosage are individual for each patient and are determined by the attending physician.
• Side effects: ulceration of the digestive tract, obesity, hirsutism, increased bone fragility, osteoporosis, decreased sexual function, decreased resistance to infections, blood clotting disorders.
• Contraindications: hypertension, diabetes mellitus, pregnancy, psychosis, nephritis, gastric ulcer and duodenal ulcer, recent surgeries, active tuberculosis, syphilis, elderly patients.
• Overdose is manifested by severe side effects. There is no antidote, so symptomatic therapy is indicated.

Prednisolone is available as tablets for oral administration, ampoules for injection, ointment for external use and eye drops.

2. Medrol

Synthetic glucocorticosteroid with the active substance methylprednisolone.

• Indications for use: endocrine diseases, rheumatological pathologies, collagenoses, allergic reactions, pathologies of the respiratory system and the hematopoietic system, oncological pathologies, gastrointestinal disorders, organ and tissue transplantation.
• The method of administration and dosage depend on the severity of the disease and the individual characteristics of the patient's body.
• Side effects: muscle weakness and musculoskeletal disorders, gastric bleeding, decreased immune system defenses, water-electrolyte disturbances and metabolic changes.
• Contraindications: hypersensitivity to the components of the drug, pregnancy and lactation.

The drug is available in the form of tablets for oral use.

3. Betamethasone

A synthetic corticosteroid with strong anti-inflammatory action.

• Indications for use: collagenoses, rheumatoid arthritis and acute rheumatic fever, scleroderma, dermatomyositis, impaired motor activity, redness and swelling of the skin, allergic rhinitis, allergic reactions, dermatoses, contact dermatitis, inflammatory eye diseases, herpes zoster, tumor diseases of the lymph nodes, hemorrhagic pathologies. Diseases of soft tissues and inflammatory lesions of the joints.
• The method of administration and dosage depend on the stage of the disease and are therefore determined by the attending physician.
• Side effects: osteoporosis, weight gain, increased blood pressure, water retention, ulceration of the gastrointestinal mucosa, insomnia, atrophy of the adrenal cortex.
• Contraindications: severe forms of hypertension, circulatory failure, osteoporosis, active tuberculosis, syphilis, pregnancy and lactation, gastric ulcer and duodenal ulcer, mental illness, systemic mycoses, glaucoma, diabetes mellitus.

Betamethasone is available in the form of tablets for oral use and as a solution for injection in ampoules.

In addition to the above medications, Metacortalon, Cordex, and Triamcinolone are used for treatment.

Chondoprotectors – the action of drugs is aimed at protecting cartilage tissue from destruction. Stimulates regeneration and nutrition processes.

1. Structum

Chondroprotective drug with the active component - chondroitin sulfate sodium salt. The active substance is the structural basis of bone and cartilage tissue. Promotes the restoration and maintenance of the normal structure of the cartilage matrix.

• Indications for use: degenerative-dystrophic diseases of the spine and joints, osteoarthritis, intervertebral osteochondrosis.
• Directions for use: Orally, 1 capsule once a day, regardless of meals, with a sufficient amount of liquid. The recommended daily dosage is 1000 mg, the course of treatment is 3-6 months.
• Side effects: gastrointestinal disorders, nausea, vomiting, dyspeptic symptoms. Allergic dermatitis, urticaria, Quincke's edema may also develop.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, patients under 15 years of age.
• Overdose: increased severity of adverse reactions. Treatment is symptomatic.

Structum stimulates the synthesis of hyaluronic acid, normalizes the viscosity of synovial fluid and homeostasis of the synovial environment of the joints.

2. Adgelon

A medicinal product with the active substance - glycoprotein. The regenerative properties of the drug are widely used in degenerative joint lesions and ophthalmological pathologies. Stops the processes of lipid peroxidation, that is, damage to cell membranes. In ophthalmological practice, it activates fibroblastic elements and stimulates corneal regeneration.

In the treatment of arthrosis, it slows down degenerative processes and stimulates cartilage regeneration. It activates the growth of fibroblasts and the proliferative action of lymphocytes. It has anti-inflammatory, antioxidant and analgesic properties. It stimulates the accumulation of chondroblasts and their transformation into chondrocytes to fill damaged areas of the joint.

• Indications for use: the solution is used for injection into the joint in case of polyarthrosis, osteoarthrosis, capsulitis and other degenerative lesions. Drops are used to treat ophthalmological pathologies with damage to the corneal membrane.
• Method of application: the solution is administered intra-articularly 2 ml twice a week or every other week. Injections are performed in a hospital in compliance with aseptic rules. To achieve a stable therapeutic effect, treatment is carried out in courses of 5-10 injections. The interval between therapeutic courses should be at least 1 month.
• Side effects: development of allergic reactions, pain at the injection site, hyperemia and swelling of nearby tissues.
• Contraindications: injections are not prescribed for symptoms of synovitis, infectious skin lesions and for the treatment of children. Therapy is not carried out in case of intolerance to the components of the drug. Use during pregnancy and lactation should be carried out with special caution.

Adgelon is available in the form of drops of 5 and 10 ml and as a solution for intra-articular injections of 2 and 5 ml in an ampoule.

3. Chondrolon

Chondroprotector with the active substance - chondroitin sulfate 100 mg. It is used in normal metabolism of cartilage tissue, replenishes the deficiency of glucosaminoglycans. Enhances synthetic processes, reduces the severity of inflammatory reactions, reduces pain. The active component enhances the synthesis of cartilage macromolecules, normalizes the balance of the processes of destruction and restoration of cartilage tissue.

Chondrolon improves blood supply to joints by inhibiting lipid synthesis and improves blood rheology. It has chondroprotective, anti-inflammatory, analgesic, regenerating and chondrostimulating effects.

• Indications for use: joint pathologies caused by degenerative dystrophic processes in the body. Used for arthrosis, reactive arthritis, osteoarthrosis, intervertebral osteochondrosis, capsulitis. Prescribed for fractures to accelerate the formation of bone callus.
• Method of administration: the medicine is used intramuscularly, diluting the lyophilisate in 1 ml of water for injection. Injections are given every other day, the course of treatment is 1-2 months.
• Side effects: allergic reactions, hyperemia, rashes, local increase in body temperature, hemorrhages at the injection site.
• Contraindications: thrombophlebitis, coagulation disorders, pregnancy and lactation, pediatric patients.

The medicine is produced in ampoules with lyophilized mass in each. There are 10 ampoules in a package.

Also, the following chondroprotective drugs can be prescribed for the treatment of capsulitis: Artra, Teraflex, Piaskledin, Alflutop, Noltrex, Ostenil, Sinocrom, Fermatron, Synvisc.

Antibiotics – are used only if the inflammatory process is caused by infectious agents. The drugs destroy pathogenic flora, accelerating recovery.

1. Tetracycline

A broad-spectrum antibiotic. It is used for inflammatory and infectious diseases of various localizations. Before using the drug, it is necessary to determine the sensitivity of the microflora that caused the pathology. As a rule, patients are prescribed 250 mg every 6 hours. The course of treatment is determined by the attending physician.

Side effects include gastrointestinal disorders, allergic skin reactions and other body lesions. Tetracycline is contraindicated in cases of intolerance to its components, fungal diseases, kidney damage and leukopenia. It is not used during pregnancy and for the treatment of patients under 8 years of age. The antibiotic has several forms of release: tablets, suspension and granules for the preparation of syrup.

2. Erythromycin

An antimicrobial agent similar in its action to penicillins. It is active against a wide range of pathogenic microorganisms. Therapeutic doses have bacteriostatic properties.

• Indications for use: infectious lung diseases, septic conditions, inflammatory pathologies, inflammation of the bone marrow and bone tissue, purulent-inflammatory processes in the body.
• Method of administration: a single dose is 250 mg, in severe conditions take 500 mg every 4-6 hours before meals. The course of treatment is determined by the attending physician, individually for each patient.
• Side effects: nausea and vomiting, bowel disorders, liver dysfunction, allergic reactions. With prolonged use, resistance may develop.
• Contraindications: hypersensitivity to the components of the drug, severe liver dysfunction, history of allergic reactions.

Erythromycin is available in the form of tablets for oral use, as well as in the form of a 1% ointment.

3. Lomefloxacin

An antibiotic from the fluoroquinolone group with the active component lomefloxacin hydrochloride. It has a broad spectrum of action and anti-tuberculosis activity, but does not act on mycoplasma, ureaplasma and streptococci.

• Indications for use: infections of the skeletal system, urinary tract, digestive system, respiratory organs, dermatological pathologies. Used in complex therapy of infectious wounds, osteomyelitis.
• Directions for use: daily dose is 400-800 mg, course of treatment is 10-14 days.
• Side effects: nausea, vomiting, increased fatigue, bowel disorders, candidiasis, nervousness, heart rhythm disturbances, allergic reactions. Overdose is manifested by an increase in the above reactions, treatment is symptomatic.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, pediatric practice.

Lomefloxacin is available as tablets in a dosage of 400 mg each.

In addition to the above-mentioned drugs, Nimid and local antibiotics Fastum and Voltaren gel are prescribed for patients with capsulitis.

Medicinal blockades are prescribed to reduce the intensity of pain.

For blockade, Novocaine is used in combination with steroids (Kenalog, Hydrocortisone) and other drugs. Injections into the affected joint can be done no more than twice a month. In this case, the risk of developing quite serious complications is taken into account: disruption of skin pigmentation, degenerative changes in tendon fibers and joint tissues, accumulation of blood in the joint cavity. Injections with the following drugs have a pronounced analgesic effect:

1. Metipred

Glucocorticosteroid hormone with the active substance methylprednisolone. Its mechanism of action is based on interaction with steroid receptors in the cytoplasm. The drug inhibits the synthesis of enzymes and proteins that participate in the destruction of joints, as well as cytokines involved in inflammatory and immune reactions. Reduces tissue response to infectious, immunological, thermal or chemical irritants.

• Indications for use: rheumatic and autoimmune diseases, allergic reactions, asthma and lower respiratory tract lesions, cerebral edema.
• The method of administration and dosage depend on the form of release of the drug. The course of treatment is determined by the attending physician, individually for each patient.
• Side effects: various gastrointestinal disorders, increased blood pressure, heart failure, emotional instability, respiratory failure. In rare cases, decreased elasticity and rupture of tendons are observed.
• Contraindications: intolerance to the components of the drug and lactose, acute and chronic viral infections. The drug is prescribed with special caution in congestive heart failure, diabetes mellitus and other endocrine pathologies. Use during pregnancy is possible only on medical prescription.

The medicine is available in several forms: tablets, lyophilized powder for preparation of injection solution and suspension.

2. Novocaine

A local anesthetic used for pain relief by infiltration, conduction, epidural and spinal methods. The dosage is selected by the attending physician, individually for each patient. Side effects include increased weakness, decreased blood pressure, allergic reactions and dizziness.

Novocaine is contraindicated in case of intolerance to its components. The medicine is available in the form of powder for solution preparation, ampoules with ready-made solution, sterile solutions in 200 and 400 ml bottles, in the form of ointment for external use and suppositories.

3. Kenalog

Synthetic glucocorticosteroid for systemic use with the active component triamcinolone acetate. Has anti-inflammatory, antiallergic and immunosuppressive effects.

• Indications for use: injection suspension is used for joint blockade in case of dysfunction of the joint capsule, dropsy of the joints, arthrosis, arthritis. Tablets are used to treat allergic diseases, chronic respiratory diseases and hay fever. The method of administration and dosage are determined by the attending physician, for each patient individually.
• Side effects: nausea, vomiting, digestive disorders, flatulence, ulcerative lesions of the stomach and duodenum, arterial hypertension, increased blood clotting, arterial hypertension, depressive states, headaches and dizziness, skin allergic reactions, endocrine system disorders, etc.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, ulcerative lesions of the stomach and duodenum, conditions after severe injuries and surgeries, diabetes mellitus, increased tendency to thrombosis and bleeding.
• Overdose: nausea, vomiting, sleep disorders, fluid retention, muscle weakness, arterial hypertension. Hemodialysis is ineffective, so a gradual reduction in the dosage of the drug is indicated until the painful symptoms are completely eliminated.

Kenalog is available in the form of tablets with 4 mg of active ingredient each and in the form of injections with 1 ml in an ampoule.

In addition to the above-mentioned drugs, Diprospan, Flosteron, Hydrocortisone and combinations of other medications are used to perform blockades.

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Vitamins

An essential component of the treatment of capsulitis and other degenerative diseases of the musculoskeletal system is vitamin therapy. Vitamins are necessary to saturate the body with useful substances, neutralize the negative effects of drugs.

Benefits of vitamins:

• Destruction of free radicals.
• Strengthening connective tissues.
• Minimization of pain.
• Activation of metabolic processes in the site of inflammation.
• Strengthening the immune system.

For capsulitis, it is recommended to take the following vitamins and minerals:

• B1 – thiamine affects nerve fibers and reduces their excitability. Has a minimal analgesic effect.
• B3 – nicotinic acid increases the range of motion in affected tissues and relieves pain.
• B5 – pantothenic acid has an analgesic effect. With prolonged use, it eliminates joint stiffness and enhances the effect of other vitamins.
• B6 – pyridoxine has a positive effect on the functioning of neuromuscular fibers. It promotes the activation of metabolism in cartilaginous tissues, improving nutrition at the cellular level.
• B12 – has an anti-edematous and anti-inflammatory effect. Relieves fatigue and promotes the synthesis of red blood cells.
• C – ascorbic acid increases bone density and prevents the development of degenerative processes. Participates in oxidation-reduction reactions of the body. Increases collagen synthesis, ensures restoration of the ligament and muscle apparatus, accelerates regeneration processes.
• E – tocopherol reduces pain, which allows to reduce the daily dosage of antiviral and analgesic drugs. Increases the range of motion in the affected joints, improves well-being.
• Omega-3 is a polyunsaturated fatty acid that prevents the destruction of bone tissue and increases the elasticity of ligaments and tendons. The substance is part of the synovial fluid, so it improves joint mobility and accelerates the recovery process.
• Selenium is an antioxidant substance that helps strengthen the immune system. It relieves pain and inflammation. It participates in the synthesis of cartilage membrane enzymes.
• Copper – has antiviral, antibacterial and analgesic properties. Participates in metabolic processes, reduces pain and swelling. Increases joint mobility and oxygen saturation at the cellular level.
• Zinc – reduces inflammation and pain.

Vitamins for capsulitis should be taken over a long period of time. Special vitamin-mineral complexes for the treatment of inflammatory joint lesions have not been developed to date. But there are drugs that can be used to strengthen the body as a whole: Duovit, Pentovit, Alphabet, Centrum. The optimal multivitamin complex should be selected by a doctor, individually for each patient after a set of diagnostic procedures and taking into account the therapy.

Physiotherapy treatment

To eliminate inflammation, reduce pain and improve metabolic processes in capsulitis, physiotherapy treatment is indicated.

Acute stage of the disease

• Magnetotherapy – the affected tissues are exposed to an alternating magnetic field. The doctor applies special magnetic inductors to the painful areas. The procedure is performed in a lying position for 10 minutes. The course of treatment consists of 5-10 procedures.
• Extracorporeal shock wave therapy – the inflammation site is affected by acoustic waves. The effect of the procedure can be compared to a course of intensive massage. The shock wave method relieves swelling, reduces pain and improves the mobility of the affected limb. Treatment is carried out once a week, the course consists of 2-5 procedures.
• Electrophoresis with painkillers - anesthetics are introduced into the affected tissues through the skin using electric current. For this, pads and electrodes soaked in the medicine are applied to the joint. The session lasts 20-30 minutes, the course of treatment is 5-10 procedures daily.
• X-ray therapy – has anti-inflammatory and analgesic properties. It is used locally on damaged tissues. X-ray irradiation suppresses the immune system, stops acute inflammation.
• Decimeter wave treatment – tissues are affected by electromagnetic waves of the decimeter range. This ensures deep penetration of impulses into tissues, resolves inflammation foci. The procedures are carried out for 30 minutes, daily for a week.

The phase of subsidence

• Paraffin applications – medicinal mixtures stimulate regeneration processes in periarticular tissues. Due to this, the recovery process is accelerated and pain sensations are minimized. Warm compresses are applied for 20-30 minutes, daily for 10 days.
• Cryotherapy – tissues are exposed to dry cold air for 5-10 minutes. The procedures are carried out daily for 10-15 days.
• Electrostatic shower – to improve metabolism in affected tissues, a high-voltage electric field is used. The procedure is carried out for 10 minutes, the course consists of 10-12 sessions.

Recovery stage

• Swimming – water treatments help to develop affected joints with minimal stress and side effects.
• Hirudotherapy - leeches are attached to the inflamed area, which, when bitten, throw a special substance into the blood. Due to this, an anesthetic effect and blood thinning occurs. Treatment with leeches has a mild anesthetic and pronounced antiseptic effect.
• Mud therapy – mud nourishes the affected tissues with beneficial substances and has a gentle warming effect.
• Acupressure massage has a local effect on the damaged area, relieves muscle spasms and restores joint mobility.

All physiotherapeutic methods are selected by the attending physician, individually for each patient.

Massage for capsulitis

One of the effective non-drug methods of treating neurodystrophic joint lesions is massage. In capsulitis, massage procedures are combined with medications for a comprehensive effect on the body and acceleration of the recovery process.

Massage has the following properties:

• Reduces pain.
• Prevents the development of the anglicizing form of the disease.
• Prevention of muscle tissue atrophy and reduction of joint activity.
• Restoration of functionality of affected limbs.
• Prevents the formation of coarse scar tissue.

In case of capsulitis of the shoulder joint, the massage is aimed at the collar zone, the scapulohumeral joint and shoulder, the large and deltoid pectoral muscles. The procedures are carried out daily for 15-20 minutes. In this case, a pronounced therapeutic effect is noticeable after 2-3 full courses with a break of 10-20 days.

The following procedures have a similar effect to massage:

1. Acupuncture – relieves pain by affecting active points of the body with the help of needles inserted under the skin. The procedure is performed manually only by a qualified specialist.
2. Taping – tapes, i.e. stickers made of a special material, are applied to the affected tissues. The adhesive tape fixes and supports the joints, relieving the load and improving blood circulation.

Massage and other manual techniques are contraindicated in the acute phase of the disease, severe pain and pronounced inflammatory process. This is due to the fact that pressure on the affected tissues can aggravate the pathological process.

Exercise therapy for capsulitis

At the recovery stage, a therapeutic exercise complex is indicated to develop the mobility of the affected joint. LFK for capsulitis is necessary for:

• Restoring muscle strength and tone.
• Strengthening ligaments.
• Prevention of the development of contracture, i.e. limited functionality of the joint.
• Normalization of blood circulation.
• Improvement and restoration of motor functions.

Gymnastics is performed during the rehabilitation period and only under medical supervision. Physical therapy includes exercises in different positions and with special equipment.

Rules for conducting exercise therapy for periarthritis:

• Gradually increase the load.
• Systematic and regular procedures.
• During gymnastics the patient should not feel pain.
• All exercises should be performed at a slow pace.

Gymnastics is contraindicated in cases of high blood pressure, risk of bleeding, fever, circulatory failure of the second stage and higher.

Exercises for capsulitis

Therapeutic physical training for capsulitis is carried out at the stage of the disease subsiding and the recovery stage. Exercises reduce pain, increase joint mobility and improve the elasticity of its capsule. Gymnastics can be carried out only after minimizing pain and acute inflammation.

The set of exercises developed by Popov is very popular and has a pronounced therapeutic effect. The basis of his exercise therapy is swinging, stretching and rotation.

Recommended exercises for capsulitis of the shoulder-scapular region:

• Raise your shoulders as high as possible and draw eights with them. During the exercise, alternate synchronous and alternate movements.
• Stand near a wall, pressing your spine firmly against it. Raise your shoulders and stretch your arms up. Slowly return to the starting position.
• In a standing position, cross your outstretched arms. As you inhale, spread your limbs, and as you exhale, cross them.
• Raise your arms and simultaneously turn your torso towards the raised arm.
• Extend your arms forward and clasp your hands together. Make a wave motion, gradually increasing the tempo, and then circular motions.
• Bend your arms at the elbows, slowly lower them down and return to the starting position.

After each exercise, Popov recommends doing warm-up exercises to work out the damaged tissues.

Exercises for severe pain:

• Lie on your back, arms along the body. Perform 10-12 rotational movements with your arms, changing the position of your palms up and down.
• From a lying position, bend your forearms at the elbows and place your hand on your shoulder. Hold this position for 2-3 seconds and return to the starting position. Perform 7-10 repetitions.
• From a supine position, spread your straight arms to the sides and raise them up. There should be no painful sensations during the exercise.

When performing therapeutic exercises, you should adhere to certain rules: gradual load, regularity, slow exercise without jerks. Systematic exercise therapy allows you to restore joint mobility. It should be taken into account that a lasting therapeutic effect can only be achieved with long-term exercise recommended by a doctor in combination with other therapeutic procedures.

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Folk remedies

In addition to classical therapy methods, some patients resort to folk remedies for capsulitis. Let's look at popular treatment recipes:

• Take 500 g of salt and heat it. Pour the salt into a thick sock or cloth bag. Apply to the affected joint for 15-20 minutes 3-4 times a day. Warming is contraindicated if the disease is in the acute inflammatory stage.
• Take equal parts liquid mustard, salt and honey. Mix everything thoroughly and apply to the affected tissues. Cover the compress with polyethylene and wrap it in a warm cloth. Leave the product on for 15-30 minutes. Perform the procedure 2-3 times a day.
• Mix ½ cup of grated hot radish and chopped horseradish with one tablespoon of vegetable oil. Mix everything well and apply to the inflamed area. Wrap the compress in parchment and a warm cloth. Remove after an hour and wash the skin with warm soapy water.

Traditional medicine cannot cure capsulitis, but it can alleviate the symptoms of the disease. Alternative methods can only be used with the consent of a doctor.

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Herbal treatment

Some plant components have pronounced medicinal properties. Herbal treatment for capsulitis is recommended to be carried out according to the following recipes:

• Take 10-20 g of dried and crushed nettle and pour a glass of boiling water. The remedy should be infused until it cools, then filter it and take 1 tablespoon 3-4 times a day.
• Pour a glass of boiling water over the dried and crushed raw material of St. John's wort and let it brew for 30 minutes. Strain and take 2-3 times a day, ¼ glass.
• Finely chop two lemons with the peel and two heads of garlic. Pour 200 g of honey over the herbal mixture. Mix everything well and take 1 teaspoon 2-3 times a day.
• Rinse fresh burdock leaves under water and apply as a compress to the inflamed area. It is recommended to leave the remedy overnight.
• Mix equal parts of crushed sweet clover, St. John's wort flowers, and hop cones. Add two tablespoons of eucalyptus and 50 g of Vaseline to the herbal mixture. Apply the prepared ointment to the sore joint and wrap it in a warm cloth.

Before using medicinal herbs, you should make sure that there are no allergic reactions.

Homeopathy

An alternative therapy, the action of which is aimed at improving the condition of the affected organ, and not at eliminating painful symptoms, is homeopathy. Its main goal is to normalize the work of all organs and systems, activating the biological mechanisms of the body.

For capsulitis, the following homeopathic preparations are used:

• Apis – burning pain in the joints, swelling and hyperemia.
• Bryonia – pain in the joints (worsening during movement and decreasing at rest), swelling of the affected tissues.
• Rus Toxicodendron - pain is localized in the ligamentous apparatus and intensifies at rest.
• Colchicum - acute pain and inflammation, joint deformation.
• Ledum - swollen joints, local temperature is elevated. Pain increases in warmth and at night.
• Sulfur - degenerative changes with damage to the skin.
• Rhododendron - joint pain combined with severe headaches and a feeling of exhaustion.

The dosage of homeopathic preparations is determined by the homeopath, individually for each patient. Despite the fact that such products contain a small amount of active components, treatment should be carried out with special caution.

Homeopathy for capsulitis is contraindicated during pregnancy, in benign or malignant lesions of the body. Such therapy is recommended to be combined with traditional medications.

Surgical treatment of capsulitis

If conservative therapy of capsulitis does not give the desired results, then surgery is performed. Surgical intervention is aimed at restoring the mobility of the affected joint. Arthroscopic techniques are often used. The main indications for their use are:

• Chronic joint pain (corticosteroid injections are ineffective).
• Recurrent pain in the affected area.
• Degenerative changes confirmed by X-ray.
• Disability.

Surgical treatment for periarthritis of the shoulder is called subacromial decompression. The technique is based on the removal of a fragment of the scapular process (acromion) and ligaments from this area. Such intervention leads to the fact that nearby tissues stop being injured during movements, contracture disappears and full functionality of the limb is restored.

After the operation, the patient will have a long recovery period. During rehabilitation, a set of physiotherapy procedures, therapeutic exercises and vitamins are prescribed. If the operation was without complications, the joint is restored within 3-5 months. According to statistics, in 95% of cases, surgery allows to avoid relapses of the disease in the future.

Rehabilitation after surgery for capsulitis

The duration of the rehabilitation period for inflammation of the synovial bursa and joint capsule depends on the volume of surgical treatment and its results. Full recovery takes from 2 to 6 months.

• 1 week – anti-inflammatory and analgesic therapy, application of cold compresses are indicated on the first day. This helps to minimize pain and swelling. The operated limb is immobilized with elastic bandages. A week later, patients are prescribed special exercise therapy.
• 1-3 weeks – during this period, rehabilitation is aimed at maintaining muscle tone and stimulating blood circulation. Passive exercises are performed to develop the limb, but with minimal load on the affected joint.
• 3-6 weeks – muscle tone is almost restored, so active gymnastics for developing the shoulder joint and a set of physiotherapy procedures are recommended. Sharp movements are contraindicated, you should also avoid increased physical activity and reduce the risk of joint injury.
• Weeks 6-12 – for full recovery, progressive strength training is recommended. For gymnastics, you can use weights and special exercise machines. Pool training is effective.

The entire rehabilitation process after capsulitis should take place under strict medical supervision. If sharp pains, swelling or hyperemia of the tissues occur during the development of the joint, then you should stop exercising and immediately seek medical help. If you follow all medical recommendations, recovery is fairly quick and without complications.