Frozen Shoulder (Adhesive Capsulitis)

What is Frozen Shoulder (Adhesive Capsulitis)? Adhesive capsulitis, or frozen shoulder, is a condition in which the shoulder cannot be moved normally due to pain and inflammation in the joint capsule of the shoulder. Limited range of motion not only occurs when the individual tries to move the shoulder, but even if shoulder movement is forced. The condition may arise due to no known cause other than lack of use of the shoulder joint.

What causes Frozen Shoulder (Adhesive Capsulitis)? Frozen shoulder is caused by inflammation, scarring or thickening that occurs within the capsule of the shoulder joint. The capsule of ligaments in the shoulder joint allows the bones in the shoulder to freely move within the joint and if this becomes inflamed, the bones in the shoulder may have difficulty moving or may not be able to move at all. In many cases, there is no known cause for the inflammation and the condition arises from lack of use of the shoulder joint, but some causes that can lead to the condition include diabetes, shoulder trauma or injury, shoulder surgery, tendonitis, bursitis, cervical disc disease, chronic inflammatory arthritis, hyperthyroidism or any type of surgery located in the chest or breast.

What will the treatment for Frozen Shoulder (Adhesive Capsulitis) consist of? Treatment for frozen shoulder includes nonsteroidal anti-inflammatory medications to treat the pain, steroid injections when needed, and intense physical therapy. Daily physical therapy is typically required for a number of months in order to improve the functioning of the joint, and may include range of motion and strengthening exercises, ultrasound, electric stimulation, steroid injections, and cold therapy. There may be additional treatments related to what initially caused the shoulder pain in the first place. If treatment is unsuccessful, surgery may be required to remove scar tissue in the shoulder arthroscopically or the shoulder may be manipulated to break up scar tissue located in the joint capsule. Surgery is followed by extensive physical therapy, although pain blocks may be required initially in order to get through the therapy. A frozen shoulder may be permanent if not treated aggressively.

What are the symptoms of Frozen Shoulder (Adhesive Capsulitis)? The primary symptoms of frozen shoulder are pain, stiffness and limited shoulder mobility. In most cases, the condition begins with pain that prevents you from using your shoulder and moving your arm in a normal fashion. The pain may have some underlying cause or no cause at all. As you cease to move your arm because of the pain or if you keep it immobilized for too long (such as by putting it in a sling), the shoulder becomes stiff and eventually you cannot perform certain functions or movements. The main difference between frozen shoulder and other conditions that may cause pain, stiffness and limited mobility is that with frozen shoulder, the doctor cannot make the shoulder joint move even by manually moving it.

How is Frozen Shoulder (Adhesive Capsulitis) diagnosed? A medical professional will take a complete medical history and will perform a physical exam. Questions will be asked related to when the symptoms began, what activities caused the symptoms, and how limited the movement of the shoulder is. The shoulder will be examined and range of motion tests will be performed. The doctor will try to move the shoulder joint manually and if that cannot be done, a diagnosis of frozen shoulder is made. X-rays, an MRI, or arthrography (an x-ray using contrast dye) may be ordered to determine if there is any noticeable cause of the immobility, but in most cases of frozen shoulder there are no specific findings, although shrinkage of the shoulder capsule or scar tissue may be apparent.

When should I seek care for Frozen Shoulder (Adhesive Capsulitis)? Any time you have any type of pain or stiffness in your shoulder that limits movement of the shoulder joint, you should see a medical professional. The best way to prevent frozen shoulder or to limit the severity of the condition is to avoid letting your shoulder sit idle without movement for an extended period of time.

Which muscle groups/joints are commonly affected by Frozen Shoulder (Adhesive Capsulitis)? Frozen shoulder occurs in the joint capsule that surrounds the shoulder and affects mobility in the shoulder.

What type of results should I expect from the treatment of Frozen Shoulder (Adhesive Capsulitis)? Daily physical therapy may be required for as long as a year in order to obtain full mobility and functionality of the shoulder joint. During that time, pain relief may be required for some time. Most individuals will experience a return to normal functionality during that time, as long as therapy continues and the shoulder is continually used. If surgery is required to treat the condition, physical therapy is required for weeks or months afterwards and surgery will not be successful if a full course of physical therapy is not followed. Even if normal range of motion is achieved following treatment, there can be some lasting pain and stiffness from this condition.