Frozen Shoulder (Adhesive Capsulitis)

Introduction

Adhesive Capsulitis or Frozen Shoulder is a disorder characterized by pain and significant loss of the full range of motion. The process involves inflammation, scarring, thickening and contracture of the capsule surrounding the shoulder joint.

Clinicians point out that many structures can be involved in the condition of frozen shoulder.

The condition is more common in individuals above the age of 50 as well as women in between the ages of 40 and 70 years old.

Frozen Shoulder - Stages

An episode of a frozen shoulder is normally progressive. The main symptom is a pain located around the shoulder joint along with restricted motion. The condition normally passes through the following stages in most patients:

Stage I - Painful stage

This is often the most painful stage. Motion is severely restricted and the stage lasts for 6-12 weeks on a whole.

Stage II - Stiffness and pain

The pain normally eases up, but the stiffness worsens. The frozen stage can last from 4-6 months in all.

Stage III - Stiffness improving

This is a very gradual stage and motion steadily improves over a lengthy period of time. This stage can extend up to more than a year.

Treatment Modalities

The treatment plan for frozen shoulder is normally based on two important goals - pain relief and rehabilitation. The treatment options for a frozen shoulder are typically categorized in two types. Here we discuss each of them briefly:

A - Non-surigcal options

These focus on pain relief and function restoration of the shoulder. Measures include:

  • Medication
  • Manual therapy to improve joint range and decrease pain
  • Physical therapy, for exercises to stretch muscles and restore motion and function to the shoulder
  • Muscle imbalance training
  • Heat and ice therapies to reduce pain and swelling
  • Electro therapy

B - Surgical options

These are resorted to if more conservative measures have failed over months and include:

Closed manipulation, involving forceful movement of the arm at the shoulder joint

Arthroscopic surgery, in order to improve movement at the joint. Performed under anesthesia, this is followed by an intensive physical therapy programme to mobilize the shoulder joint.