The shoulder junction is a very dynamic structure that has a wide arc of motion and can move
in sagittal, vertical and transverse planes, and provides the connection between the trunk
and the upper extremity. Due to this dynamic structure, the shoulder junction is a joint
where soft tissue pathologies are common. One of the most common of these pathologies is
adhesive capsulitis or frozen shoulder (DO). DO has been defined by different names and with
some minor differences in the literature for over 100 years. It has been defined by various
names such as adherent obliterative bursitis, adhesive bursitis, periarticular fibrositis,
scapulohumeral periarthritis, Duplay periarthritis, adhesive capsulitis. DO was first defined
as "scapulohumeral periarthritis" in 1896 by Duplay. In 1934, Codman used the term "frozen
shoulder" and suggested that it is seen together with rotator cuff tendinitis. The most
widely accepted is the definition made by Neviaser in 1945. It is a disease picture
characterized by pain and limitation of movement in the shoulder joint, which is defined as
inflammation in the capsule and synovium first, followed by adhesion formations, especially
in the axillary fold and the attachment of the capsule to the anatomical neck of the humerus.
Although the exact mechanism of action of vagus nerve stimulation is not known, studies on
humans have shown that it affects many areas of the brain at the subcortical and cortical
level. A high peripheral sympathetic tone causes regional ischemia, which causes widespread
pain. Therapeutic interventions that result in vasodilation (eg, exercise) and appropriate
autonomic changes have proven to be effective on pain. The vagus nerve, the "great perfect
protector" of the body, encompasses a complex neuro-endocrine-immune network that maintains
homeostasis. With reciprocal neural connections to multiple areas of the brain, the vagus
nerve serves as a control center that integrates sensitive information and provides
appropriate feedback responses. Recent studies show that the vagus nerve is involved in
inflammation, mood and pain regulation. All of these can be modulated with vagus nerve
stimulation. Vagus nerve stimulation, together with an extensive vagal nerve network, can
exert a neuromodulatory effect that will activate some natural protective pathways for health
restoration.
Recent preclinical studies show that vagus nerve stimulation is very potent and effective in
modulating pain in humans. A medical device allowed the auricular branch of the vagus nerve
to be stimulated without any surgery. As a result, it was found that the pain threshold
increased and the mechanical pain sensitivity decreased. As a result of the studies, there is
a possibility that Frozen Shoulder is a disease that occurs with OSS disorder. Vagus nerve
stimulation can be used as an adjunct therapy to correct OSS disorder. Since there is no
study in the literature on vagus nerve stimulation in Frozen Shoulder, such a study was
considered.