Frozen Shoulder (Adhesive Capsulitis)
Limited motion is an early symptom of a frozen shoulder (also known as
Adhesive Capsulitis), which is a general term denoting all causes of motion
loss in the shoulder. It affects more women than men, with onset occurring
usually between ages 40 and 65. Approximately 10% to 20% of diabetics
may be at risk of developing the condition, as well as those who have
suffered trauma or overuse injuries. Patients with hyperthyroidism, cardiovascular
disease, clinical depression or Parkinson’s disease may also be
predisposed to developing a frozen shoulder.
Causes of Frozen Shoulder
The causes of frozen shoulder are unknown, although it most likely involves
an underlying inflammatory process. The capsule surrounding the shoulder
joint thickens and contracts, leaving less space for the upper arm bone
(humerus) to move. Frozen shoulder can also develop after a prolonged
immobilization because of trauma or surgery to the joint. Usually only
one shoulder is affected, although in about one-third of cases, motion
may be limited in both arms.
Frozen Shoulder Symptoms
If you’re having trouble lifting your arm above your head, reaching
across your body or behind your back, you may have a problem with the
range of motion in your shoulder. Frozen shoulder develops slowly, and
in three stages:
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Stage One: Pain increases with movement and is often worse at night. There is a
progressive loss of motion with increasing pain. This stage lasts approximately
2 to 9 months.
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Stage Two: Pain begins to diminish, and moving the arm is more comfortable. However,
the range of motion is now much more limited, as much as 50 percent less
than in the other arm. This stage may last 4 to 12 months.
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Stage Three: The condition begins to resolve. Most patients experience a gradual restoration
of motion over the next 12 to 42 months; surgery may be required to restore
motion for some patients.
Frozen Shoulder Treatments
Treatment is aimed at relieving the discomfort and restoring motion and
function to the shoulder. Nonoperative treatments include muscle relaxers
and medications (such as aspirin or ibuprofen) to reduce the inflammation
and relieve the pain; heat or ice therapies; corticosteroid injections;
and a program of physical therapy, often combined with home exercises
and other therapies, to stretch and help restore motion and function.
Surgery is an option, but only if there is no improvement after several
months. Arthroscopic surgery can successfully release and repair the shoulder,
but it must be mobile.