Adhesive capsulitis or “frozen shoulder” is a very painful condition that occurs from inflammation of the capsule of the shoulder. As the capsule becomes more thickened and inflamed, patients complain of pain and decreased range of motion.
Causes, Symptoms & Diagnosis
Causes: Adhesive capsulitis is classified as primary or secondary. Primary adhesive capsulitis can be caused by hormonal imbalance, immune system changes, diabetes mellitus, and some cardiovascular disorders. It often affects both shoulders and does not always respond well to conservative treatment. Secondary adhesive capsulitis is usually the result of injury, persistent impingement syndrome, or simply not moving the shoulder joint.
Symptoms include pain and decreased range of motion.
Diagnosis can be made by obtaining a thorough history and performing a pertinent physical exam. X-rays or MRI are often used to rule out other pathology.
Non-operative treatment includes PT, NSAIDS, ultrasound, ice and heat. The goal of treatment is to restore normal range of motion.
Failure on non-operative treatment can lead to a manipulation under anesthesia with an arthroscopy to release the tightened capsule.
Early range of motion with PT is strongly encouraged to ensure that the joint stays mobile. Home stretching exercises are performed between PT visits. Once range of motion is achieved, strengthening exercises are added to the therapy program.