About frozen shoulder (adhesive capsulitis)

What is frozen shoulder (adhesive capsulitis)?

Frozen shoulder

Frozen shoulder occurs when the connective tissue enclosing the joint becomes thickened and tight.

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.

Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy.

Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely.

It's unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder.

What are the symptoms for frozen shoulder (adhesive capsulitis)?

For some people, the Pain worsens at night, sometimes disrupting sleep.

What are the causes for frozen shoulder (adhesive capsulitis)?

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture.

What are the treatments for frozen shoulder (adhesive capsulitis)?

Shoulder exercises 

These exercises may improve your shoulder's range of motion. Let your arm hang down like a pendulum, and then gently swing it back and forth or in circles. Pretend your fingers are your feet and walk your fingers up a wall.

Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible.

Medications

Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others), can help reduce pain and inflammation associated with frozen shoulder. In some cases, your doctor may prescribe stronger pain-relieving and anti-inflammatory drugs.

Therapy

A physical therapist can teach you range-of-motion exercises to help recover as much mobility in your shoulder as possible. Your commitment to doing these exercises is important to optimize recovery of your mobility.

Surgical and other procedures

Most frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms, your doctor may suggest:

  • Steroid injections. Injecting corticosteroids into your shoulder joint may help decrease pain and improve shoulder mobility, especially in the early stages of the process.
  • Joint distension. Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.
  • Shoulder manipulation. In this procedure, you receive a general anesthetic, so you'll be unconscious and feel no pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightened tissue.
  • Surgery. Surgery for frozen shoulder is rare, but if nothing else has helped, your doctor may recommend surgery to remove scar tissue and adhesions from inside your shoulder joint. Doctors usually perform this surgery with lighted, tubular instruments inserted through small incisions around your joint (arthroscopically).

What are the risk factors for frozen shoulder (adhesive capsulitis)?

Certain factors may increase your risk of developing frozen shoulder.

Age and sex

People 40 and older, particularly women, are more likely to have frozen shoulder.

Immobility or reduced mobility

People who've had prolonged immobility or reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:

  • Rotator cuff injury
  • Broken arm
  • Stroke
  • Recovery from surgery

Systemic diseases

People who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk include:

  • Diabetes
  • Overactive thyroid (hyperthyroidism)
  • Underactive thyroid (hypothyroidism)
  • Cardiovascular disease
  • Tuberculosis
  • Parkinson's disease

Is there a cure/medications for frozen shoulder (adhesive capsulitis)?

Frozen shoulder (adhesive capsulitis) is a condition in which the movement of the shoulder becomes difficult due to stiffness.

On the basis of symptoms and medical history, medications are decided.

Diagnosis:
1. Physical examination of arms and shoulders are done.

2. Moving shoulder in all direction with the help of doctor

3. Passive range of motion and active range of motion both are compared

4. X-rays of the shoulder is done

5. Imaging test i.e. MRI (magnetic resonance imaging), ultrasound are done

Cure/medications
1. Hot and cold compresses are recommended.

2. Medications such as nonsteroidal anti-inflammatory drugs, ibuprofen and acetaminophen,advil, motrin IB and other painkillers are prescribed.

3. For severe pain, steroid injections are given. Corticosteroids injections are given into the shoulder joint.

4. Physical therapy can be beneficial.

5. Shoulder manipulation is done.

6. Home exercises are recommended.

7. A small battery operated device i.e. transcutaneous electrical nerve stimulation helps in reducing pain by blocking nerve impulses.

8. Shoulder arthroscopy is done in which a small pencil-sized instrument is inserted around the shoulder.

Symptoms
Freezing stage: Movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited,Frozen stage: Pain may begin to diminish during this stage, but your shoulder becomes stiffer, and using it becomes more difficult,Thawing stage: The range of motion in your shoulder begins to improve
Conditions
Stiffness and pain in your shoulder joint
Drugs
Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others),Pain-relieving and anti-inflammatory drugs

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