Adhesive Capsulitis, or Frozen Shoulder as it is commonly known, is a condition characterized by inflammation, scarring and tightening of the connective tissue (ligament capsule) surrounding the shoulder joint. This results in shoulder pain and a marked loss of shoulder movement. Frozen shoulder affects 2-3% of the population, and particularly women greater than men.
The shoulder is a ball and socket joint, encapsulated by a strong connective tissue holding the bones together known as the shoulder joint capsule. Whilst the exact cause of a frozen shoulder is not known, the joint capsule often becomes inflamed and symptoms associated with this condition then usually develop gradually over time. However it can also develop following a recent history of minor or serious shoulder injury, surgery and/or period of immobilisation.
The picture above shows an internal view of a shoulder with immense inflammation and scarring, due to Adhesive Capsulitis.
Patients typically experience a dull ache that may increase to a sharper pain with certain movements or activities. Pain tends to be focused deep in the shoulder, however may occasionally be experienced in the upper arm, upper back and neck and you may also experience stiffness in each of these regions.
Patients also typically experience stiffness and significantly reduced range of movement of the shoulder, particularly with motions required for grooming, performing overhead activities, dressing, and reaching behind the back or for the seatbelt. You may also experience pain at night or upon waking in the morning.
As the condition progresses, it often presents three distinct phases. They are inflammatory phase, stiffness phase, then a resolution or 'thawing' phase. Each phase may last for months, and studies have shown complete resolution can take 8-40 months.
Treatment consists of many options, the first being a tailored physiotherapy regime. This involves specific stretching exercises initially, and the graduated strengthening of the shoulder muscles. Our Melbourne Sports Physiotherapists also provide expert hands-on manual treatments for soft tissue mobilisation to complement the exercise program. If you are not improving, your Physiotherapist may refer you to a shoulder orthopaedic specialist, for their opinion. They may offer:
Hydrodilitation Injection ( to stretch the joint capsule and calm the inflammation with cortisone)
Manipulation Under Anaesthetic
Following all of these interventions, follow up physiotherapy is highly recommended.