Frozen shoulder or adhesive capsulitis results in a painful stiff shoulder. This condition usually occurs in people between the ages of 40 and 60. It is more common in women and people with diabetes, thyroid disease, or cardiac disease. It also can occur as a result of trauma or immobilization of the shoulder.
Adhesive capsulitis, frozen shoulder, begins with inflammation in the lining of the shoulder joint. The first symptom is pain, and as the pain worsens loss of motion occurs. This stage usually lasts 6 weeks to several months. After this period, the frozen stage occurs. This stage is characterized by less pain, but worsened stiffness and more adhesions (or scarring) within the shoulder joint. After several months the thawing stage begins. During this stage gradual improvement in motion and function occurs. The entire process can take about 2 years.
Treatment of frozen shoulder, or adhesive capsulitis, varies depending on the stage. In the initial freezing stage, oral anit-inflammatory medications and sometimes cortisone injections can be helpful in decreasing the inflammation. Physical therapy is then used to stretch the shoulder to help improve and maintain range of motion. When frozen shoulder is diagnosed and treated in this early stage, pain and function can often be regained quickly.
Once the frozen stage has begun, anti-inflammatories and cortisone injections are often less helpful. In addition, the dense scar that has formed in the joint is often resistant to physical therapy. Yet, these healing methods are still tried first. If range of motion does not improve and the patient does not want to wait for “thawing” to occur, then the shoulder can either be manipulated under anesthesia (while you are sedated the shoulder is forcibly moved in a controlled fashion) or an arthroscopic surgery can be done. This type of surgery includes small incisions along the shoulder; the scarred capsule tissue is then released to regain motion. These treatments are then followed by physical therapy to maintain motion.