Frozen Shoulder (Adhesive Capsulitis)

What is adhesive capsulitis or frozen shoulder?

Frozen shoulder, or adhesive capsulitis is characterized by significant shoulder stiffness due to thickening of the capsule surrounding the shoulder joint.

What is the shoulder capsule and how does it affect my motion?

Your shoulder is a ball and socket joint made up of three bones: your upper arm bone, your shoulder blade, and your collar bone.  Surrounding the ball and socket joint, is strong connective tissue called the shoulder capsule.  The shoulder capsule contains the joint fluid that helps lubricate the joint.

What causes frozen shoulder?

The causes of frozen shoulder are not fully understood.  There are a few factors, however, that put people at risk for developing frozen shoulder.

Diabetes – frozen shoulder occurs more often in patients with diabetes, affecting 10-20% of these individuals.  The reason for this is still not known.

Immobilization – frozen shoulder commonly develops after the shoulder has been immobilized for a period of time due to surgery, fracture, or other injury.  Finding the delicate balance between adequate immobilization to help repair the injury and excessive immobilization leading to a frozen shoulder can be difficult.  This reason is one of many that patients can benefit from treatment of shoulder problems by a shoulder specialist, like myself.

What are the symptoms of frozen shoulder?

The hallmark symptom of frozen shoulder is the inability to move your shoulder in any direction.  Pain is also normally associated with this, especially at the beginning of the process.

How is frozen shoulder diagnosed?

A frozen shoulder can be diagnosed by a shoulder specialist by listening to your history and physical examination.  On physical examination, I normally find that patients are unable to move their shoulder in any direction.  Sometimes, x-rays or advanced imaging like an MRI or ultrasound can be helpful in the diagnosis.  Many times, however, the diagnosis is made by history and physical examination.

What is the treatment for frozen shoulder?

A vast majority of patients with frozen shoulder can be treated without surgery.  Non-operative treatment consists of a combination of home exercises and physical therapy.  Continue reading here to see my shoulder rehabilitation protocol for frozen shoulder.

What if my shoulder does not improve with home therapy and physical therapy?

Infrequently, your shoulder motion may not fully improve with a combination of home exercises and physical therapy.  This process may take up to one year, however.  If you have been actively working with home exercises and physical therapy for a year, you may be a candidate for a shoulder arthroscopy and capsular release.  This minimally invasive surgery involves opening up the shoulder joint by releasing the tight shoulder capsule.  After surgery, you immediately return to home exercises and physical therapy to maintain your improved shoulder motion.