| > Site Map |
| Shoulder & Elbow
Disorders (other than fractures and dislocations) > Frozen Shoulder (Adhesive Capsulitis) What is Frozen Shoulder? ("Adhesive Capsulitis") Adhesive capsulitis is a painful condition in which the shoulder loses its range of motion. This condition is also referred to as “frozen shoulder” because of how difficult it is for a person to move his or her shoulder. The shoulder is not actually frozen, just stiff. A healthy shoulder has a wide range of unrestricted motion. Three bones make up the shoulder: the scapula (shoulder blade), the humerus (upper arm bone) and the clavicle (collarbone). The shoulder joint capsule is a bag of tissues made up of ligaments. Ligaments attach bones to bones. In a normal shoulder, this capsule contains some joint fluid that lubricates the joint surfaces allowing the shoulder to easily move. Adhesive capsulitis causes scar tissue to form in the shoulder region. The condition usually goes through various stages until it is treated. In the beginning, the shoulder may feel stiff and ache and gradually become very painful. This stage can last up to eight months. The second stage is referred to as the adhesive stage and it is when the shoulder becomes even stiffer. This stage usually lasts 4 to 6 months and is generally less painful than the first stage. The final stage lasts about one to three months. At this time, it usually becomes easier to move the shoulder. Pain may exist still and you won’t get the full range of motion back with treatment. Causes of Frozen Shoulder? An injury to the shoulder joint such as rotator cuff injury can cause adhesive capsulitis to form. Other conditions that can lead to adhesive capsulitis include tendinitis and bursitis. However, the condition can form without any warning and, in general, the cause is unknown. This type of condition appears more commonly in people with diabetes, chronic (longterm) inflammatory arthritis of the shoulder or after chest or breast surgery. If the shoulder has been immobilized for a long period of time, adhesive capsulitis could develop as a result. Some doctors believe that the condition could also develop as a result of an autoimmune reaction. The body thinks it is under attack during an autoimmune reaction and will start to attack parts of itself causing an inflammatory reaction in the tissues. As a result, the shoulder can lose its range of motion and adhesive capsulitis will form. Symptoms of Frozen Shoulder? The basic indicator of adhesive capsulitis is the inability to move the shoulder in all directions without severe pain. It will hurt regardless if you are moving the shoulder or someone else is moving it for you. The movement will simply stop as if there was something preventing the shoulder from moving any further. In addition, the pain may increase at night. A normal shoulder should allow you to reach up to the sky with both arms and feel no pain. A doctor will have to examine your shoulder and ask for your medical history to be able to accurately diagnosis your condition. Other conditions have similar symptoms to adhesive capsulitis so your doctor may need to take an x-ray to look for other problems. He or she may inject dye into the shoulder joint and then perform an x-ray called an arthrography. This technique will let your doctor know if your condition is adhesive capsulitis or another related condition. Treatments of Frozen Shoulder? Successful treatment of adhesive capsulitis include the following three elements:
Treatment can be a long process. Initial treatment is aimed at reducing inflammation and pain and increasing the range of motion of the shoulder. Exercise is a very important part of the treatment. The exercises will help break up the scar tissue in the shoulder and should be done twice a day. Your doctor or physical therapist will show you what kind of exercises should be performed. Since the exercises may be painful, using ice packs afterwards may help. As with all exercises, you should warm up before attempting to do them. If treatment is stalled, your doctor may suggest a manipulation of the shoulder while you are under anesthesia. During a manipulation, your doctor reduces or breaks up the scar tissue in the shoulder and stretches the shoulder joint. This procedure can speed up the healing process and may be repeated if necessary. However, there is a small chance the arm bone may break during this procedure. It is very important to properly exercise the shoulder after a manipulation so that mobility is returned. Arthroscopic surgery may also help break up the scar tissue. This procedure is done on an outpatient basis. A camera is inserted through a small incision allowing the doctor to access the damage to the joint and, at the same time, aid in the healing process. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |