Adhesive Capsulitis (“Frozen Shoulder”)


 

What is a frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, is a painful condition in which the movement of the shoulder becomes limited and gradually worsens over time. The condition occurs when the strong connective tissue surrounding the shoulder joint (called the shoulder joint capsule) becomes thick, stiff, and inflamed. It is commonly due to an idiopathic (unknown) cause, but can also occur following trauma, overuse, or surgery.

 

What causes a frozen shoulder?

There are many different risk factors that contribute to the development of adhesive capsulitis:

  • Age – typically occurs in adults 40 to 60 years old
  • Gender – more common in women than men
  • Recent shoulder injury – Any shoulder injury or surgery that results in the need to keep the shoulder immobile for an extended period of time
  • Diabetes – Between 10-20% percent of individuals with diabetes develop frozen shoulder
  • Other health diseases and conditions – stroke, hypothyroidism, Parkinson’s, and heart disease

 

What are the symptoms of a frozen shoulder? 

The hallmark symptom of adhesive capsulitis is the inability to move the shoulder, which is caused by stiffening of the joint capsule and scar tissue formation. Decreased range of motion is typically accompanied by pain that is worse in the early stages of the condition. Symptoms of a frozen shoulder can be divided into three stages:

  • "Freezing" stage: The shoulder becomes stiff and range of motion begins to decrease, as the pain slowly increases. It may worsen at night. This stage lasts 6 to 12 weeks
  • "Frozen" stage: Pain may begin to decrease, but the shoulder remains stiff making it more difficult to complete daily tasks and activities. This stage typically lasts 3 to 6 months
  • "Thawing" (recovery) stage: Range of motion improves as the pain continues to lessen. Full or near full recovery occurs as normal strength and motion return. The stage lasts 6 months to 2 years

 

What is the treatment for a frozen shoulder? 

Unfortunately, there is no quick cure for a frozen shoulder. Typically, the symptoms gradually improve without treatment, but it may take up to 2 years for the condition to resolve. The overall goal of treatment is to limit pain and help patients regain their range of motion. One of the best prevention methods is to regularly perform exercises that maintain the shoulder range of motion.   

Non-surgical – Initial treatment of adhesive capsulitis includes conservative measures, such as rest, ice, anti-inflammatory medications and physical therapy. Corticosteroid injections may also be helpful in limiting inflammation and helping shorten the duration of the disease.

 

Surgical – In extreme cases and those who fail conservative treatment, Dr. Potts may recommend surgery with a procedure to break up the tough scar tissue around the joint. This is known as a manipulation under anesthesia.  In many cases, this will be combined with shoulder arthroscopy to debride the scar tissue within the shoulder joint capsule. Aggressive physical therapy is initiated promptly after surgery to maintain movement in the shoulder.

 

 

AREAS OF TREATMENT