Adhesive capsulitis, or frozen shoulder is a term for pain and stiffness in the shoulder joint that is so severe that the shoulder cannot be moved, either by the patient or another person. The condition affects the tissues that envelop the ball and socket joint of the shoulder and the ligaments that hold the shoulder bones together. Some people have the condition in one shoulder, while others have it in both. Further explaination is given below on Adhesive Capsulitis: Causes, Symptoms, and Treatment | ShoulderMD.
Adhesive Capsulitis: Causes
Doctors do not know what causes frozen shoulder, though some believe it part of the body’s inflammatory response to an injury. Some people who have had a shoulder injury develop scar tissue, or adhesions that keep the shoulder from being able to move. Their shoulder may also have less synovial fluid than usual. This fluid helps joints move smoothly and easily. Most people who get frozen shoulder are over 40, and most are women.
The risk of having adhesive capsulitis increases if:
- The person is diabetic or has a thyroid problem.
- They have been forced to be immobile for a long time, either due to an injury or to surgery.
- They engage in a sport where they overuse their shoulder joint.
Symptoms of Adhesive Capsulitis
There are three stages of frozen shoulder. In the first stage, the person feels an ache or a pain in their shoulder. At first it is mild, but it becomes so severe that it interferes with their ability to sleep or do daily tasks. The pain worsens whenever they try to move their shoulder. This first stage lasts from two to nine months.
In the second stage the pain lessens, but the stiffness gets worse. This prevents the person from being able to move their shoulder normally. A vicious cycle is set up. Because the person cannot move their shoulder normally, the stiffness increases, which then further restricts the range of motion. This stage lasts for about four to 12 months.
The last stage is the recovery stage. The range of motion in the shoulder slowly increases. This stage can last from one year to several years.
Adhesive Capsulitis and Treatment
The orthopedist will examine the shoulder and take a medical history of the patient. They may order imaging tests to get a better look at what is going on in the shoulder. Treatment includes:
- Exercises and physical therapy to help the shoulder joint move. Most of the exercises can be done at home by the patient
- Ultrasound, electrical stimulation or acupuncture
- Manipulation of the shoulder. This needs to be done under anesthesia because the goal is to break up the scar tissue in the shoulder joint. After the manipulation, the patient still needs to do exercises.
- If the treatment doesn’t work after several months, the doctor might recommend shoulder surgery. This surgery is done arthroscopically. This means that small incisions are made and the surgeon operates by way of a fiber optic camera attached to a monitor. The surgical instruments are also miniaturized. This reduces the recovery period and the risk of surgical complications.