Frozen Shoulder: Adhesive Capulitis

What is Frozen Shoulder?

Frozen shoulder or adhesive capsulitis, as it is otherwise known, is a debilitating, painful condition that more often than not, appears out of the blue, usually in people over forty and is characterized by painful, limited movement, most often in one arm but very occasionally, in both.

The condition is progressive, primariy affecting the free rotation of the shoulder joint. Everyday activities, such as dressing or brushing hair, which involve the affected arm become very difficult. Frozen shoulder causes the tissue in the cavity around the shoulder joint to become inflamed, forming adhesions which result in stiffness and restricted movement. Moving the arm above the head or behind the back becomes a hard action to perform, thus making simple activities like dressing, problematic.

Adhesive Capsulitis progresses in three stages:

Pain and Freezing - Characterised by pain, which is worse at night and increases with movement and may last several months

Stiffness or frozen - Pain may lessen but motion becomes restricted - may last up to a year

Resolution - Resolving over time, however sometimes it can take three years

Restricted Movement

The shoulder joint is sometimes described as akin to a ball rolling around in a chin cup and if something interferes with the smooth rolling of the ball, problems occur. In very severe cases movement of the arm may become so severely restricted, it is virtually rendered useless. When it interferes with the normal running of a sufferer's life, it can be a very distressing condition that may exacerbate or cause associated depression and anxiety.

However there is light at the end of the tunnel as frozen shoulder will usually resolve itself...eventually. Unfortunately, recovery can be very slow - anywhere from 12 months to two years or longer. The condition affects about 2% of the population and for reasons unknown, more women than men suffer from from it. In Japan the condition is known as "fifties shoulder" as this is the age group most affected.

Risk Factors

The exact cause is unknown but there are certain known risk factors which have been implicated as being associated with the condition. These include:

  • Diabetes
  • Age (most common after 45)
  • Thyroid Disorders
  • Cervical disk disease of the neck
  • Shoulder injury
  • Open Heart Surgery
  • Stroke

Symptoms and Stages of Frozen Shoulder

Typically, frozen shoulder progresses through three distinct stages: it may begin slowly, with pain and discomfort, after which, the pain may lesson but the condition will have progressed to stiffness and limited movement and motion of the affected arm. In the final stage the stiffness begins to "thaw" and movement slowly returns.

Soothing gel pack
Soothing gel pack

Treatment

Frozen shoulder should always be diagnosed by a physician as there is always the possibility pain and stiffness in the arm and shoulder may have another cause.

Without treatment, the condition will resolve itself in around two years, however regular physical therapy can greatly improve motion and reduce healing time by as much as a year.

Pain may be treated with anti-inflammatory drugs and in some cases, steroid injections.

Rarely, if non-surgical treatment proves ineffective, surgery under anaesthetic may be indicated, though physical therapy will still be required post-operation while it lasts, it does help to know that it's not forever and with dedicated, daily treatment it may even be resolved within nine months.

Generally people with frozen shoulder eventually make a complete recovery with no loss of motion in the affected arm and shoulder. While it's a debilitating, life-interfering condition,

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