Adhesive capsulitis of the hip: a case report: an entity in question

Very little has been discussed in the medical literature concerning adhesive capsulitis of the hip (ACH). There are no articles to date in the physical therapy literature regarding ACH and only a dozen or so in medical journals. Evidence suggests ACH may present in a similar progression through four stages as adhesive capsulitis of the shoulder (ACS) (from synovial inflammation to capsular fibrosis). Consensus does not exist for management of ACS or ACH. However, most clinicians agree that treatment should be guided by the stage of the disorder, whether medically, surgically, or through physical therapy. A large part of the confusion for management of adhesive capsulitis (ACS and ACH) is due to the many studies that have not reported their findings by stage. Arthroscopy and synovial/capsular biopsy can confirm the presence and stage of adhesive capsulitis. Primary (idiopathic) ACH is proposed to be caused by biomechanical dysfunction in the hip or other joints related to the mechanical function of the hip. The treatment for stages 1 and 2 consists of using techniques to reduce inflammation and correct biomechanical faults that affect the hip. In stages 3 and 4 treatment focuses on the biomechanical dysfunction of the spine, hip(s), pelvic ring, and lower limb, if needed. In this case, the 55-year-old female patient presenting with probable stage 3 adhesive capsulitis, responded well to manual therapy and has been able to return to functional activities and maintain them with a home program.