What Is Frozen Shoulder (Adhesive Capsulitis)?

Frozen shoulder, or adhesive capsulitis, is a spectrum of disorders in the shoulder characterized primarily by a significant limitation in motion. This may or may not be associated with pain. Most commonly this occurs after an injury to the shoulder, but can also develop as a result of underlying medical conditions.

The limitation in motion is due to adhesions, inflammation and scar tissue formation, and not because of lack of muscle strength or due to muscle tears such as a rotator cuff tear. Classically frozen shoulder  follows a pattern of 3 phases. The "Freezing" phase (phase 1) is characterized by both pain and limited motion. The "Frozen" phase (phase 2) is typically present when the pain has resolved, but significant limitation in motion persists. The "Thawing" phase (phase 3) is the process of regaining range of motion. This whole process can take several months and even greater than a year and a half to resolve.

Physical therapy is the mainstay of treatment for frozen shoulder, but the underlying cause must be determined as well. Often, physical therapy will be augmented with the use of anti-inflammatory medications, possibly injections of steroids into the shoulder, and even surgery. The surgery can be a "manipulation" where the patient is placed under anesthesia for sedation and pain control and the adhesions are manually released with specific stretching maneuvers. Some patients will benefit from a shoulder arthroscopy to surgically break up adhesions and scar tissue to provide improved motion.

The key is to make the correct diagnosis and to start the appropriate treatment early.

 

 

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