In adhesive capsulitis, at which stage(s) will anesthesia testing show range of motion that is nearly identical to awake testing?

In adhesive capsulitis, at which stage(s) will anesthesia testing show range of motion that is nearly identical to awake testing?

• A. Stage 2 or 3
• B. All stages
• C. Stage 4
• D. There is no stage with similar ROM

Answer: (A)

When anesthesia testing is used, you’re trying to tell whether ROM loss is due to pain guarding or actual structural restriction of the joint. If pain and guarding are driving the limitation, removing pain under anesthesia will reveal much more motion than you see awake. In adhesive capsulitis, by the time you reach Stage two and Stage three, the capsule has become stiff enough that the movement is primarily limited by mechanical contracture rather than by pain alone. So, even with the joint relaxed under anesthesia, the ROM remains largely restricted and is very similar to what you measure when the patient is awake. That’s why Stage two or three is the best choice. In earlier stages, you’d expect more ROM under anesthesia, and in later stages the patterns shift as thawing begins, so the ROM change wouldn’t align with those stages.

When anesthesia testing is used, you’re trying to tell whether ROM loss is due to pain guarding or actual structural restriction of the joint. If pain and guarding are driving the limitation, removing pain under anesthesia will reveal much more motion than you see awake. In adhesive capsulitis, by the time you reach Stage two and Stage three, the capsule has become stiff enough that the movement is primarily limited by mechanical contracture rather than by pain alone. So, even with the joint relaxed under anesthesia, the ROM remains largely restricted and is very similar to what you measure when the patient is awake. That’s why Stage two or three is the best choice. In earlier stages, you’d expect more ROM under anesthesia, and in later stages the patterns shift as thawing begins, so the ROM change wouldn’t align with those stages.