关节造影扩张
一篇荟萃分析证实用盐水及皮质类固醇激素冲洗膨胀关节可以在短期改善疼痛、关节活动度及功能。[39]Buchbinder R, Green S, Youd JM, et al. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2008;(1):CD007005.http://www.ncbi.nlm.nih.gov/pubmed/18254123?tool=bestpractice.com
玻璃酸钠注射液
有少量证据支持使用玻璃酸钠注射液缓解疼痛。[49]Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg Am. 2008;90:970-979.http://www.ncbi.nlm.nih.gov/pubmed/18451387?tool=bestpractice.com
持续被动活动
在疾病早期对缓解疼痛有益。[50]Dundar U, Toktas H, Cakir T, et al. Continuous passive motion provides good pain control in patients with adhesive capsulitis. Int J Rehabil Res. 2009;32:193-198.http://www.ncbi.nlm.nih.gov/pubmed/19011582?tool=bestpractice.com
蜂毒针灸
一项临床随机对照显示治疗12周时蜂毒针灸结合物理治疗比单独物理治疗获得了更好地功能,疼痛减轻程度也更轻。仍需更多的试验及长期数据来证实这些结果。[51]Koh PS, Seo BK, Cho NS, et al. Clinical effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a randomized controlled trial. J Shoulder Elbow Surg. 2013;22:1053-1062.http://www.ncbi.nlm.nih.gov/pubmed/23352187?tool=bestpractice.com
体外冲击波治疗 (ESWT)
作为口服皮质类固醇的替代治疗,显示出前景,对缓解疼痛和改善活动范围,有短期益处。[52]Chen CY, Hu CC, Weng PW, et al. Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis. J Shoulder Elbow Surg. 2014;23:1843-1851.http://www.ncbi.nlm.nih.gov/pubmed/25441567?tool=bestpractice.com鉴于使用 ESWT 可成功治疗其他纤维化疾病,例如掌腱膜挛缩症和佩罗尼病,它们的病理过程与粘连性关节囊炎相似,因而可合理推测这种治疗具有巨大的潜力。
脉冲射频刺激
一项随机对照试验显示,对肩胛上神经进行脉冲射频刺激(超声引导)联合物理疗法具有前景。这项研究发现,相对于长达 12 周的单独物理疗法,联合疗法可更好更快地缓解疼痛、减少残疾和改善被动活动范围。[53]Wu YT, Ho CW, Chen YL, et al. Ultrasound-guided pulsed radiofrequency stimulation of the suprascapular nerve for adhesive capsulitis: a prospective, randomized, controlled trial. Anesth Analg. 2014;119:686-692.http://www.ncbi.nlm.nih.gov/pubmed/25010824?tool=bestpractice.com