What is Frozen Shoulder or Adhesive Capsulitis?
Frozen shoulder is a painful inflammatory condition of the shoulder in which the shoulder loses motion over time. Pain and stiffness continue to be the overwhelming issue which causes further loss of motion of the shoulder.
Mechanism of Injury
There usually is some initial event, whether it be from overuse or an acute injury, that leads to pain and loss of function of the shoulder. This often continues to fester and patients typically lose more motion as they do less with their shoulder and stiffen up. Patients with uncontrolled diabetes often develop frozen shoulder due to their medical condition of not controlling their sugars. 50-70% of uncontrolled diabetics will develop this painful condition sometime in their lifetime.
Diagnosis and Symptoms
Frozen shoulder usually starts with pain in the shoulder resulting in the inability to move the shoulder normally. Over time and without preserving the motion of the shoulder, the shoulder will continue to stiffen and cause significant discomfort. Inability to reach your hand above the shoulder or decreased motion in the shoulder compared to the unaffected shoulder is synonymous with this diagnosis. X-rays can help differentiate arthritis of the shoulder joint or other conditions that may cause shoulder discomfort. Advanced imaging (Ultrasound or MRI) can be helpful to rule out soft tissue pathology of the shoulder but is not required to diagnose frozen shoulder.
Treatment
Unfortunately, frozen shoulder is one of the more painful disorders of the shoulder and can be long lasting. However, it is one of the most treatable shoulder problems without requiring surgery. Conservative management includes initial rest, ice or heat, and anti-inflammatories. Cortisone Injections can help reduce the inflammation that often causes the discomfort but is not recommended for uncontrolled diabetics. The mainstay of treatment is rehabilitation. Physical therapy (PT) will focus on stretching of the joint capsule and range of motion of the shoulder. The success of PT and the speed at which recovery occurs will depend on the active participation of the patient. This condition requires long term management but the more exercises that are done as symptoms resolve, the faster this problem will improve. Surgery can be considered for those that fail conservative management but fortunately this condition rarely requires this invasive treatment.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.org/en/diseases–conditions/frozen-shoulder