Frozen Shoulder (adhesive capsulitis)
Learn more about common pain disorders, their development, and pain mechanisms.
Definition and Causes
Frozen Shoulder, also known as adhesive capsulitis, is a common shoulder condition characterized by severe day and night pain and limited movement in the shoulder joint. It is caused by an inflammatory thickening of the joint capsule, followed by capsular contraction. This condition typically occurs between the ages of 40 and 70, with women being more frequently affected than men. The exact cause is unclear, but it can develop spontaneously or follow other shoulder pathologies or surgeries. Despite being highly restrictive, the condition is generally self-limiting and tends to resolve within 12-48 months.
Symptoms
The onset of Frozen Shoulder is gradual. Initially, there is a persistent pain, which later progresses to a noticeable restriction in movement. Raising the arm forward, sideways, and rotating it outward become particularly challenging. After a prolonged stiff phase, the shoulder’s range of motion slowly returns.
Diagnosis
Frozen Shoulder is diagnosed clinically through patient history and physical examination. The main diagnostic indicator is a reduced and end-range painful passive external rotation with the arm adducted.
Treatment
- Initial Phase (Inflammatory Phase): Treatment focuses on managing inflammation and pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed.
- Interventional Treatments: Nerve blocks targeting the suprascapular and axillary nerves, or intra-articular shoulder injections, can be used to alleviate pain.
- Physical Therapy: Initially, during the inflammatory phase, physical therapy is not recommended as it can be counterproductive. However, during the freezing and thawing phases, physical therapy is crucial for improving shoulder mobility.
By following these treatment guidelines, patients with Frozen Shoulder can manage symptoms effectively and expedite recovery.
