Adhesive capsulitis is commonly referred to as Frozen shoulder. This is an inflammatory condition that causes thickening and adhesions of the shoulder capsule provoking pain and leading to progressive loss of shoulder mobility. Patients suffering from adhesive capsulitis typically present with a sudden and progressive onset of pain in the front of one shoulder often causing difficulty sleeping at night. Patients often experience progressive loss of external rotation and abduction of the shoulder which limits daily activities such as reaching in overhead cabinets, buckling a seatbelt, washing or combing hair, dressing oneself, and personal hygiene.
What are the common causes of Frozen Shoulder?
While there is some debate over the exact cause of Adhesive Capsulitis there are many known contributing, and risk factors associated with developing the condition. Some associated causes are immobilization of the shoulder following surgery or trauma to the shoulder such as a rotator cuff tear, impingement, or tendinitis causing increased inflammation and non-use of the arm.
Other risk factors associated with developing Adhesive Capsulitis include age, Adhesive Capsulitis most commonly occurs between 40-65 years of age with females more commonly affected than males. There is also a strong link between other health conditions such as diabetes, Hyper and Hypothyroidism, Complex regional pain syndrome, and patients with a history of Dupuytren’s contractures. In addition, patients who have had frozen shoulder in the past also have a 15% likelihood of developing it in the opposite shoulder.
How long does recovery take for Frozen Shoulder?
While there are many factors that decrease recovery time, including Physical Therapy, a complete recovery of full range of motion may take up to 1-3 years. Adhesive capsulitis can be broken down into 3 stages; “Freezing”, “Frozen”, and “Thawing”.
The “Freezing” stage is the initial phase of adhesive capsulitis. This stage is characterized by pain that is typically worse at night accompanied with gradual loss of shoulder range of motion. This stage can last anywhere from 2-9 months.
The “Frozen” stage is the second phase of adhesive capsulitis. This stage is characterized by persistent restriction with shoulder range of motion and less pain than during the “Freezing” stage. This stage can occur from months 4-12.
The “Thawing” stage is the final phase of adhesive capsulitis. During this stage there is a gradual return of range of motion. This last stage usually occurs between months 12-42.
What can I do If I suspect a frozen shoulder?
See your Physical Therapist or Physician early for evaluation. Physical Therapy is often a first line of defense and the sooner you contact your physical therapist, the sooner you will receive appropriate information on how to most effectively address your symptoms. Your physical therapists’ goal is to restore your movement and reduce your pain, so you can continue to perform your daily activities. This is achieved by developing a personalized plan of care based off your symptoms, function, comorbidities, and stage of Adhesive Capsulitis.
References:
Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013; 43: A1– A31. https://doi.org/10.2519/jospt.2013.0302
Mezian K, Chang KV. Frozen Shoulder. [Updated 2019 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482162/#