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Adhesive capsulitis of the shoulder, the medical term for “Frozen Shoulder”, is a stiffness in the shoulder joints that is due to overgrowth of fibrous tissue within the shoulder joint. This tissue is known as the shoulder capsule.
In many cases, there is no history of injury or there is a very mild injury. Many patients will say that they woke up with a sore shoulder one morning which just kept getting worse. In any case, a proliferative process of fibrous tissue growth ensues rapidly and results in pain and reduced mobility. This condition typically worsens over weeks to months.
Frozen shoulder is most common in women, and is more likely to occur between the ages of 40 and 60. If you are recovering from a stroke or a surgical procedure that prevents the movement of your arm, that can increase your risk of developing frozen shoulder. Medical conditions like heart and thyroid disease, Parkinson’s, and diabetes have also been linked to frozen shoulder.
The symptoms of frozen shoulder have three distinct stages, and develop over a period of weeks-months. The first is the “freezing stage”, where shoulder mobility begins to decay as pain increases. Next is the “frozen stage”, in which pain is reduced but the ability to use the shoulder becomes increasingly difficult. The third is referred to as the “thawing stage” in which pain can decrease, and some mobility returns. This final stage can take months, even over a year, to reach without treatment.
Frozen shoulder is diagnosed via a physical exam given by your primary or orthopedic physician. They will check the extent to which you can move your shoulder, and the pain you experience during movement. If the doctor cannot conclusively diagnose you with frozen shoulder from a physical exam alone, they may order more extensive testing. This can include an MRI, ultrasound, or x-rays; this is in an effort to rule out conditions with similar symptoms, like a torn rotator cuff.
Traditional treatment of adhesive capsulitis with NSAIDs and physical therapy. If these fail, injection of the joint may be performed to decrease the inflammatory response. When these measures fail and symptoms persist, orthopedic surgeons may recommend “manipulation under anesthesia” which involves general anesthesia to paralyze the patient so that the orthopedist can manually manipulate the arm in range of motion to break up the fibrous tissue.