Adhesive Capsulitis (Frozen Shoulder)
What is adhesive capsulitis?
Adhesive capsulitis, also referred to as frozen shoulder, is a painful condition of the shoulder that causes decreased range of motion of the glenohumeral joint. The capsule that normally surrounds the head of the humerus (arm bone) becomes inflamed and stiff causing a decrease in range of motion.
Adhesive capsulitis is most common in middle-aged women and is often related to a minor injury or some form of stress. It is more common in those with a history of thyroid disease or diabetes. Initially, shoulder pain may be noticed during certain activities. However, pain may also occur at rest. Patients then note difficulty finding a comfortable sleeping position. Over a period of weeks to months, you may progressively experience discomfort and a loss of range of motion in the shoulder.
What are the symptoms?
Adhesive capsulitis typically develops in three stages, with each stage usually lasting three to four months.
During this stage, pain can occur with any movement or while at rest. It may be difficult finding a comfortable sleeping position.
Pain may begin to diminish during this stage; however, shoulder range of motion also begins to decrease. Patients may notice they are not able to reach into their back pocket or comb the back of their hair.
During this stage the condition slowly improves and range of motion is slowly regained.
What are the causes?
The cause of adhesive capsulitis is unknown. Since it is more common in people with diabetes, it is theorized that in some it may have an autoimmune component, meaning the immune system may be attacking a healthy body part or there is a malfunction in the brain's injury recognition system.
What is the treatment?
The best treatments are resting, taking pain medications when needed and learning to live with a limited range of motion.
Some patients may benefit from a closed manipulation of the shoulder. A closed manipulation is physical therapy of the shoulder while the patient is under anesthesia. Due to the anesthesia component, this is done at a surgical center. Patients are put to sleep with a general anesthesia, and the physician moves the shoulder in all directions in order to regain the shoulder's range of motion.
In addition to a closed manipulation, some patients may benefit from a cortisone injection, which decreases inflammation and stimulates circulation in the shoulder joint.
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