Frozen shoulder (Adhesive capsulitis) : Symptoms | Diagnosis | Treatment

Frozen shoulder (Adhesive capsulitis): Symptoms | Diagnosis | Treatment

Overview

Frozen shoulder also is known as adhesive capsulitis is a common condition in people aged 40 - 65 years and is characterized by stiffness and pain in the shoulder joint. Symptoms typically begin gradually and worsen over time. It is more common in women and people with disorders like diabetes and thyroid.
It can occur due to trauma, immobility, or reduced mobility as seen in patients recovering from other medical conditions. However, the exact cause of the disease is not yet clear.
Treatment is mainly aimed at reducing pain and stiffness and restoring the function of the joint. Frozen shoulder/Adhesive capsulitis is a self-limiting disease and the usual recovery time is around 2-3 years.

What are the symptoms of the frozen shoulder?

Pain and stiffness along with the limited range of motion with both active and passive movements are the principal symptoms. However, the disease progresses slowly and has three stages as follows :

1) Inflammatory stages: It usually lasts for 4-6 months and the patient complains of severe pain in the shoulder disproportionate to the visible extent of the disease. There is a restriction of the active and passive movements with a limited range of motion.

2) Freezing stage: Pain begins to diminish in this stage but the shoulder gets stiffer and stiffer and shoulder movements become more difficult. This stage lasts for 4-6 months.

3) Thawing phase: This is a recovery phase as the shoulder begins to regain its motion and it lasts up to one year.
The total duration of the frozen shoulder is usually about 2-3 years.

What are the risk factors for frozen shoulder?

Frozen shoulder is an idiopathic disease however there are certain risk factors that may increase your risk of getting the disease such as :

A) Age and sex: It is commonly seen in patients aged 40 years or older with peak incidence seen in 40-65 years of age. Females are more prone to the disease than men.

B) Immobility or reduced mobility: patients with prolonged immobility or reduced mobility are at a higher risk. It can be a result of previous trauma such as :

1) Rotator cuff injury (Tear)
2) Stroke
3) Broken arm

C) Systemic diseases: People with certain diseases are at more risk of developing the disease such as-

1) Diabetes

2) Hypothyroidism

3) TB

4) Parkinson's disease

How frozen shoulder is diagnosed?

Diagnosis of the frozen shoulder is usually clinical and does not require any extensive diagnostic workup. However, an X-ray of the shoulder is advised by the doctor to rule out arthritis as it also causes pain and a limited range of motion.

How is frozen shoulder treated?

Frozen shoulder is usually a self-limiting disease and usually gets better over time and The main aim of the treatment is to relieve pain and restore motion.

1) Anti-inflammatory medication: NSAIDs are preferred over others and drugs like aspirin, ibuprofen, and naproxen can be given to the patients to control pain and restore motion.

2) Steroid injection: If the oral medications are not providing any relief then the patients are shifted onto the injectables. Steroids are potent anti-inflammatory agents and are injected directly into the shoulder joint.

3) Physical therapy: It is used as a supportive treatment and can help in restoring the motion of the shoulder. physical therapy mainly involves stretching and range of motion exercises.

4) Surgical treatment: Most of the patients with frozen shoulders recover over time and can be treated with conservative methods. However, in some patients, intractable pain and stiffness can demand surgical methods of treatment. Common surgical methods involve manipulation under general anesthesia and arthroscopic release. However, the surgical methods should be used only as the last resort as it can cause nerve damage further complicating the condition.