Adhesive capsulitis, a common cause of what is known to most people as frozen shoulder, is a condition that occurs when the capsule that surrounds the ball joint in the shoulder begins to form scar tissue. This scar tissue causes a drastic decrease in mobility (hence the “frozen” aspect), as well as severe pain. Not every frozen shoulder is Adhesive Capsulitis.
What Causes Frozen Shoulder?
It is often unknown what causes frozen shoulder to take hold, but there are several factors that can play a part in the likelihood of a person being diagnosed.
Those factors include:
- Age and gender- Frozen shoulder typically affects patients between the ages of 40 to 60 years old. It is much more common in women than men.
- Endocrine disorders- Patients with diabetes are at a particular risk for developing frozen shoulder, but other endocrine abnormalities can also lead to the development of this condition, such as thyroid problems.
- Shoulder trauma or surgery complications- Patients with a shoulder injury or shoulder surgery can develop a frozen shoulder joint. The risk is even higher when the injury or surgery is followed by prolonged joint immobilization.This is usually not the same as Adhesive Capsulitis, but may be treated in a similar way.
- Other systemic conditions- Pre-existing conditions like heart disease and Parkinson’s disease have been known to be a factor for people who suffer from frozen shoulder.
What Are the Treatment Options for Frozen Shoulder?
According to the American Academy of Orthopedic Surgeons (AAOS), 90 percent of patients with frozen shoulder improved range of motion and had a decrease in pain due to light and consistent physical therapy.
Exercises that might be incorporated into a physical therapy treatment plan include:
- External rotation
- Stand in a doorway, then bend affected arm 90 degrees in order to reach the doorjamb. Keep hand in place while rotating the body. Hold for 30 seconds. Relax and repeat
- Forward flexion
- Lie on back with legs straight. Use unaffected arm to lift affected arm overhead until there’s a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat
- Crossover arm stretch
- Gently pull one arm across chest just below chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat
In addition to physical therapy and exercise, a physician might prescribe the following:
- Non-steroidal anti-inflammatory medicines
- Drugs like Aspirin® and Ibuprofen® can temporarily reduce pain and swelling
- Steroid injections
- Cortisone injections are injected directly into the shoulder joint to work as a powerful anti-inflammatory
If symptoms related to frozen shoulder are not relieved through conservative treatment options, then surgery might be recommended, although this is not very common
There are two different procedures that are most commonly used in treating frozen shoulder:
1. Manipulation under anesthesia
During this procedure, the patient is put to sleep, and the shoulder is moved in ways that can stretch and tear the stiff adhesions. This will allow relief from the tension that the adhesions cause and can increase range of motion.
2. Shoulder arthroscopy
In this procedure, a doctor cuts through tight portions of the shoulder capsule. This is done by inserting pencil-sized instruments through very small incisions around the affected area. This method breaks up scarring tissue and allows for increased range of motion and eventual pain relief after recovery.
Sometimes, the two procedures are performed in tandem in order to achieve the best possible results.
What Is the Window of Recovery After a Procedure?
The best possible results are achieved by patients who thoroughly follow their rehabilitation plan. Recovery times vary depending on the severity of a patient’s frozen shoulder, ranging typically from six weeks to nine months.
If the rehabilitation process is followed thoroughly, outcomes are usually very positive. The range of motion is restored, and pain generally becomes non-existent.