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.