Adhesive Capsulitis (Frozen Shoulder)
Frozen shoulder (adhesive capsulitis), also known as “stiff shoulder,” is a condition that can cause great discomfort and limitation to shoulder movement. In most cases, it leads to a total loss of shoulder function and movement. The pain, discomfort, and immobility can become so severe that they hinder or even prevent daily activities.
Adhesive capsulitis is the technical term used to describe the thickening and tightening of the soft tissues (joint lining) of the shoulder joint. This leads to contractures and scar tissue, resulting in loss of movement. Over time, shoulder pain causes it to move less, worsening the stiffness. The loss of movement can be due to other problems, such as labral tears, impingements, or rotator cuff issues.
Primary adhesive capsulitis: Primary adhesive capsulitis occurs when the patient gradually loses shoulder mobility for no apparent reason. It is more common in middle-aged women and is often misdiagnosed as rotator cuff disease or impingement. The underlying cause of this pathology is unknown but is believed to be inflammatory. It can be EXTREMELY painful. Other possible causes include changes in the immune system or hormonal imbalances. Certain diseases like diabetes mellitus and some cardiovascular and neurological disorders may contribute. Primary adhesive capsulitis can affect both shoulders (though typically not simultaneously) and may be refractory to non-surgical treatment. Surgery can be helpful in the most severe cases.
Secondary adhesive capsulitis: Secondary (or acquired) adhesive capsulitis develops as a consequence of a known cause, such as stiffness secondary to an injury, fracture, or previous shoulder surgery, or prolonged immobilization. This condition may require surgical intervention in the most severe cases.
Physical therapy plays a fundamental role in treating most patients with frozen shoulder. Regardless of the stage of frozen shoulder they are in, an orthopedic physical therapy program can be implemented, which can be very successful in regaining joint mobility and reducing pain. As a complement to therapy, anti-inflammatory medications and steroid injections can help reduce pain, inflammation, and stiffness. This program offers gradual improvement, which can take several months.
Some people will require surgery. In those cases, arthroscopic surgery is likely to be used to release tight areas and remove scar tissue to restore mobility. Arthroscopic surgery is a minimally invasive shoulder procedure with small incisions to avoid additional damage and scar tissue.
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