An adhesive capsulitis, also known as frozen shoulder, is a condition that affects the shoulder joint. It causes pain, stiffness, and a reduction of movement in the shoulder joint.
There is no clear cause for frozen shoulder, but it may be caused by inflammation and scarring of the capsule surrounding the shoulder. A capsule is a thin layer of tissue that helps the shoulder move smoothly. When the capsule becomes inflamed, thickened, and tight, it restricts the shoulder's movement.
Some factors that may increase the risk of developing frozen shoulder are:
Age: Frozen shoulder is more common in people over 40 years old, especially women.
Immobility: Keeping the shoulder still for a long time, such as after an injury, surgery, or stroke, can lead to frozen shoulder.
Systemic diseases: Certain diseases, such as diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease, can make frozen shoulder more likely.
Frozen shoulder typically develops in three stages:
Freezing stage: The shoulder becomes painful and starts to lose its range of motion. This stage can last from 2 to 9 months.
Frozen stage: The pain may decrease, but the stiffness and limited movement persist. This stage can last from 4 to 12 months.
Thawing stage: The shoulder gradually regains its mobility and function. This stage can last from 5 to 24 months.
The symptoms of frozen shoulder may vary from person to person, and may worsen at night or in cold weather.
Symptoms, onset, duration, and severity of frozen shoulder can usually be determined by a physical examination and medical history. In addition, the doctor will check the shoulder's active and passive ranges of motion, which determines how far it can move without and with assistance.
Sometimes, imaging tests, such as X-rays, ultrasound, or MRI, may be ordered to rule out other possible causes of shoulder pain and stiffness, such as arthritis, rotator cuff injury, or bursitis.
The main goals of treatment for frozen shoulder are to relieve pain and restore the shoulder’s function. The treatment options may include:
Medications: Pain relievers, such as aspirin, ibuprofen, or acetaminophen, can help reduce pain and inflammation. Stronger anti-inflammatory drugs or corticosteroids may be prescribed or injected into the shoulder joint.
To prevent further shoulder damage, physical therapists can teach exercises to improve the range of motion and strength of the shoulder. The exercises should be done regularly and gently.
A hydrodilatation involves injecting sterile water into the shoulder capsule to stretch and loosen the tissue. It may be combined with corticosteroid injections to reduce inflammation.
Manipulation of the shoulder joint involves moving the joint under general anesthesia to break up scar tissue and improve mobility. It may cause some pain and swelling following the procedure, and it may involve nerve or bone damage.
The surgery for frozen shoulder is rare and is usually reserved for severe or persistent cases that do not respond to other treatments. With this procedure, small incisions are made in the shoulder capsule and scar tissue is removed with a camera and instruments. Recovery time and physical therapy may be required.
Frozen shoulder may not be completely preventable, but some measures that may help reduce the risk or severity of the condition are:
Keeping the shoulder active and moving, especially after an injury, surgery, or stroke.
Doing gentle stretching exercises for the shoulder regularly, especially if prone to stiffness or have a chronic disease.
Seeking medical attention for any shoulder pain or discomfort that lasts longer than a few weeks.
Managing any underlying conditions that may affect the shoulder, such as diabetes, thyroid disorders, or cardiovascular disease.
