Adhesive Capsulitis (Frozen Shoulder)

Adhesive capsulitis (frozen shoulder) describes a painful and stiff shoulder or physical motion loss in the shoulder.  People between the ages of 40 and 60 years old are more susceptible to this disease and is more commonly found in women. There does not seem to be a linkage between arm dominance or occupation.

Adhesive capsulitis occurs when the surrounding area of the shoulder joint contracts and thickens.

We have not found the exact cause of adhesive capsulitis yet. However, we do know some factors that contribute to this condition.  It sometimes occurs when the shoulder is not in used for long periods of time. Adhesive capsulitis is more commonly found in people with diabetes. The increased likelihood of this disease is also linked to Parkinson’s disease, cardiac disease or surgery, hypothyroidism, or hypothyroidism.

In frozen shoulder, there is not a sufficient amount of synovial fluid. The lubrication of this shoulder joint that this fluid provides helps the shoulder joint move. As the shoulder capsule swells, thickens, and tightens, scars and lesions would form inside the shoulder capsule. This would cause less room for the shoulder joint to move, making the shoulder feel painful and stiff. The difference between a frozen shoulder and a mild stiff shoulder pain is the decrease of space between the ball of the upper arm bone and the shoulder capsule.

Symptoms of adhesive capsulitis include an aching and dull pain around the shoulder area. This pain can sometimes radiate towards the upper arm. One of the most common symptoms of the frozen shoulder is the limited range of motion of the shoulder (a.k.a, the stiff or “frozen” shoulder). Sometimes, the shoulder joint would become so stiff, it is debilitating.

Some people are unable to carry out day to day activities such as raising one's arm or reaching up a shelf. The shoulder movement is most painful when there is a rotation of the shoulder. Many people would say that the pain and stiffness of the shoulder would worsen at night, when the arm is in motion, or if one's arm is to be accidentally bumped. The “freezing” would be the painful part of a frozen shoulder. This could last from six to nine months. This is characterized by the slow onset of a painful sensation. The shoulder would lose its motion as the pain increase. In the second stage of this disease, the shoulder would loosen up and the pain would decrease. However, the stiffness would still be present. Finally, during the last stage of this disease, they should be recovering or “thawing”.

Physicians can generally diagnosis adhesive capsulitis from the symptoms the patient would be showing. This disease can be diagnosed by an MRI or Xray. Adhesive capsulitis can be treated with many different treatments.

Usually, adhesive capsulitis can improve without any special treatment. However, the improvements will generally take about two to three years. Ninety percent of adhesive capsulitis patients undergo various non-surgical treatments such as heating pads, physical therapy, corticosteroid injections, and anti-inflammatory medications. Surgery is a measure only taken when non-surgical treatments do not work over a period of time. The surgery's goal is to release and stretch the shoulder's joint capsule. The surgeon will force the shoulder to move and this will make the joint capsule tear and stretch. Another surgical procedure that can be done on an adhesive capsulitis patient involves a tiny incision around the shoulder. Then, the surgeon will use small instruments to cut the joint capsule's tightness, using a small camera to see. This will let the shoulder to move and rotate freely post-surgery.

To prevent adhesive capsulitis, one should regularly move or rotate the shoulder. This should start to hurt when it freezes. Since shoulder pain hinders shoulder movement, any adhesion advancements will prevent and restrict shoulder movement. Physical therapy and other exercises will help with continuous movement of the shoulders.

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