...less medical jargon in a 'Quick Glance' format!
Also known as “frozen shoulder.” Adhesive Capsulitis is a shoulder joint with significant loss of its range of motion in all directions. The range of motion is limited not only when the patient attempts motion, but also when the doctor attempts to move the joint fully while the patient relaxes. A frozen shoulder is also referred to as adhesive capsulitis.
Frozen Shoulder appears to occur in THREE main phases:
In the first stage, shoulder pain increases with movement and gets worse at night. As the pain increases, so does loss of motion. This phase usually lasts 2 to 9 months.
During the second stage, the arm may be easier to move, but range of motion is limited – close to 50 percent less than the other arm. This phase may last 4 to 12 months.
The third stage involves a resolution of the condition. Over a 12 to 24-month period, the sufferer will experience gradual improvement in the mobility of the shoulder. However, treatment is usually necessary to achieve proper motion.
Frozen shoulder is the result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the normal shoulder joint. Any injury to the shoulder can lead to frozen shoulder, including tendinitis, bursitis, and rotator cuff injury. Frozen shoulders occur more frequently in patients with diabetes, chronic inflammatory arthritis of the shoulder, or after chest or breast surgery. Long-term immobility of the shoulder joint can put people at risk to develop a frozen shoulder.
The treatment of a frozen shoulder usually requires an aggressive combination of antiinflammatory medication, cortisone injection(s) into the shoulder, and physical therapy. Without aggressive treatment, a frozen shoulder can be permanent.
Diligent physical therapy is often key and can include ultrasound, electric stimulation, range-of-motion exercise maneuvers, ice packs, and eventually strengthening exercises. Physical therapy can take weeks to months for recovery, depending on the severity of the scarring of the tissues around the shoulder.
It is very important for people with adhesive capsulitis to avoid reinjuring the shoulder tissues during the rehabilitation period. These individuals should avoid sudden, jerking motions of or heavy lifting with the affected shoulder.
Sometimes frozen shoulders are resistant to treatment. Patients with resistant frozen shoulders can be considered for release of the scar tissue by arthroscopic surgery or manipulation of the scarred shoulder under anesthesia. This manipulation is performed to physically break up the scar tissue of the joint capsule. It carries the risk of breaking the arm bone. It is very important for patients that undergo manipulation to partake in an active exercise program for the shoulder after the procedure. It is only with continued exercise of the shoulder that mobility and function is optimized.