Adhesive capsulitis, commonly referred to as frozen shoulder, is a common condition that causes pain and stiffness in the shoulder. This condition is the result of a tightening or thickening of the capsule of connective tissue that protects the structures of the shoulder. Although the exact cause of frozen shoulder is unknown, it often occurs after a shoulder injury or shoulder surgery, or as a complication of diabetes. Symptoms of frozen shoulder tend to worsen over time, however, even without treatment, symptoms may resolve on their own in about two years time.
Symptoms of Adhesive Capsulitis
Patients with frozen shoulder often initially experience pain in the shoulder. Pain is the most significant complaint and can be quite severe. Most patients do not recall any specific injury. As a result of the pain, they favor the shoulder and protect it, resulting in more stiffness. The stiffer the shoulder becomes, the more painful it is.
Once the painful phase has passed, the shoulder is stiff with loss of motion. This is usually most noticeable reaching over head, and behind the back.
Eventually, the shoulder may progress into a thawing phase, during which pain and stiffness subside and range of motion is slowly restored.
Diagnosis of Adhesive Capsulitis
Adhesive capsulitis may be diagnosed after a review of symptoms and a physical examination of the shoulder. The diagnosis is usually made from the history and physical examination alone. It is more common in patients with diabetes and thyroid disorders. Additional diagnostic tests that may be performed include X-rays or an MRI scan to rule out any other conditions that may be causing symptoms.
Treatment of Adhesive Capsulitis
Treatment for frozen shoulder usually focuses on managing pain, and retaining range of motion as the condition progresses. Treatment may include:
- Anti-inflammatory medication
- Corticosteroid injections
- Physical therapy
- Manipulation under Anesthesia
- Arthroscopic Debridement
A doctor may also perform a shoulder manipulation procedure by moving the shoulder joint in different directions to help loosen the tightened tissue. If other treatment is unsuccessful, arthroscopic surgery may be performed to stretch or release the contracted joint capsule.