Adhesive Capsulitis (Frozen Shoulder)
Adhesive Capsulitis is when the shoulder motion is stiff and restricted.
Adhesive capsulitis, also called “frozen shoulder,” is a painful condition that results in dramatic shoulder stiffness and loss of motion. It is caused by inflammation around the shoulder that causes the capsule surrounding the joint to tighten up and scar. Because of the complex anatomy around the shoulder, this can cause a significant amount of pain in the back, around the scapula (shoulder blade), or in the neck. When shoulder motion is restricted, the muscles controlling the scapula become overworked and fatigue and spasm easily. Regaining motion in the shoulder joint and re-training these muscles to work normally will help with the neck and back pain.
Frozen shoulder can be caused by any number of things including trauma or an associated rotator cuff tear. In many cases, however, there is only a minor trigger or no identifiable cause at all. Frozen shoulder generally improves on its own, although it may take up to 2-3 years for someone to completely recover.
Frozen shoulder is associated with diabetes and 10-20% of people with diabetes seem to experience this at some time. Patients with a family history of diabetes are also predisposed to having frozen shoulder. These patients are harder to treat and recurrence is more common. Frozen shoulder has also been associated with significant changes in estrogen levels, like those occurring at menopause, after breast cancer chemotherapy, or after stopping hormone replacement. Other medical problems associated with frozen shoulders include thyroid disorders, Parkinson’s disease, cardiac disease, or any recent surgery or significant medical illness.
Treatment of adhesive capsulitis is focused on increasing range of motion and decreasing the amount of pain to the shoulder. Treatment is largely focused on non-operative treatments such as physical therapy, anti-inflammatory medications, and injections to help the shoulder “thaw” or regain the shoulder’s range of motion. Surgical options such as manipulations and arthroscopy are reasonable alternatives only when all other conservative treatments have failed.