Frozen no more: conquering painful rehabilitation in refractory adhesive capsulitis through continuous interscalene block with PCA

Abstract

Adhesive capsulitis, commonly known as frozen shoulder, is a progressive painful condition characterized by limited active and passive range of motion (ROM) in all planes of glenohumeral joint movement due to inflammation, fibrosis, and capsular contracture. Frozen shoulder is divided into 3 main phases: freezing, frozen, and thawing. Conventional management of frozen shoulder often yields suboptimal results. Severe pain intensity can hinder the patient's rehabilitation process, necessitating innovative analgesic methods. A 50-year-old male with a history of frozen shoulder phase adhesive capsulitis for one month, experiencing rest pain VAS 6/10 and active movement pain VAS 9/10, had received conventional therapy including intra-articular steroid injections and nerve blocks with PRF. The patient experienced severe pain during rehabilitation, so a Continuous Interscalene Brachial Plexus Block (CISB) guided by ultrasound, connected to patient controlled analgesia (PCA) as an analgesic modality, was performed. Rehabilitation continued with passive and active shoulder manipulation. CISB with PCA represents a valuable analgesic strategy in adhesive capsulitis, allowing early physiotherapy and functional recovery when conventional therapies fail.

Abbreviations: AC: Adhesive capsulitis, CISB: Continuous Interscalene Block, PCA: patient controlled analgesia, ROM: range of motion,

Keywords : Adhesive Capsulitis, Continuous Interscalene Block (CISB), Frozen Shoulder, Pain Management, Patient Controlled Analgesia (PCA),

Citation:  Setiawan MS, Mulyawan E, Hariyanto H. Frozen no more: conquering painful rehabilitation in refractory adhesive capsulitis through continuous interscalene block with PCA. Anaesth. pain intensive care 2026;30(3):380-383. DOI: 10.35975/apic.v30i3.3181

Received: December 2, 2025; Revised: January 11, 2026; Accepted: February 21, 2026