Frozen Shoulder – Adhesive Capsulitis

Frozen shoulder, also called adhesive capsulitis, is a thickening and tightening of the soft tissue capsule that surrounds the glenohumeral joint, the ball and socket joint of the shoulder.

Causes

Trauma is the most common cause of frozen shoulder.  Trauma can be iatrogenic as well, meaning caused by medical or surgical manipulation of the shoulder.  One concern for surgical rotator cuff repairs is a resulting frozen shoulder.  Atraumatic adhesive capsulitis often occurs in women moreso than men and has a strong correlation with thyroid disease and diabetes mellitus.  The most common cause of atraumatic adhesive capsulitis, however, is “idiopathic” meaning unknown.

Symptoms

The major symptoms of frozen shoulder are severe pain moving the shoulder in any direction and significant loss of motion and most often occur in patients in the 40-60 year old age range.  Pain frequently occurs first then loss of motion.  The painful, “freezing” phase can last 8 months.  The severe range of motion restriction, or “frozen” phase can last 8 months, and the “thawing” or resolution phase can last another 8 months.  Patients with adhesive capsulitis on one side are at higher risk for developing it on the contralateral side.

Procedures

Procedure-wise, cortisone injections into the glenohumeral joint can help with pain and allow better participation in physical therapy.  There is a procedure called a large volume capsular distention as well, where a large volume (in the neighborhood of 20mL’s) of saline is injected into the shoulder joint to distend the capsule and breakup adhesion.

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