What is Adhesive Capsulitis?

Adhesive capsulitis is also known by the more common name, frozen shoulder. This is a disorder that affects usually one shoulder, and inhibits its ability to move properly. It can also cause pain, especially in the early part of the illness, but it is fortunately a condition from which most people recover fully, though this can take a few years.

The basic cause of adhesive capsulitis is thickening of the shoulder capsule, which is made up of connective tissue. This tissue surrounds the functional aspects of the shoulder, and it begins to squeeze the tendons, bones, and ligaments, which in turn results in much lower range of motion. It’s hard to predict when this will occur, but people who have had their arm in a sling seem to be slightly more at risk.

Frozen shoulder also seems to occur more often in people who have diabetes, thyroid conditions, and Parkinson’s disease. There is a higher incidence of this condition occurring in women, and it most affects people in middle age. Additionally, those who’ve had injuries to the shoulder before, or had surgery on the shoulder are more likely to get adhesive capsulitis.

There are three discrete stages that a person with adhesive capsulitis will undergo. Initially, the shoulder gets hard to move, and thus arm movements may be restrictive. Any movement can be painful and the shoulder may throb even when in a resting state, especially when people are trying to sleep at night.

Pain tends to decrease as people begin the second stage of frozen shoulder. Yet the shoulder becomes more frozen. It is as though gradually the shoulder becomes less and less useful, and the same side arm may be difficult to move. The last stage is sometimes called the thawing stage. Just as adhesive capsulitis caused tightening of the capsule, it begins to gradually release it so that people are able to move the shoulder joint again, though it takes time to regain full range of motion.

There isn’t much in the way of testing that needs to be done to diagnose adhesive capsulitis and doctors usually diagnose on presence of symptoms alone. On the other hand, occasionally a doctor will rule out other conditions by using x-rays or other scans to make sure no injury exists. Most of the time, treatment is pretty straightforward too.

Doctors may treat pain from the condition with non-steroidal anti-inflammatory drugs (NSAIDs) or occasionally opiate drugs like codeine or hydrocodone if NSAIDs are not sufficient. Some doctors favor injecting corticosteroids into the shoulder muscle to relive pain, but others feel corticosteroids should be avoided since repeated injects may damage shoulder recovery. Similarly there are some surgical procedures that may be tried, though many feel these are most appropriate if the frozen shoulder is not thawing as it should, or if range of motion is severely impaired.

Either a doctor or a physical therapist may work with the person with adhesive capsulitis to help improve the condition via movement and exercise. Therapy to teach shoulder stretches can be very helpful, and may be especially important during the thawing stage, to regain full range of motion. Use of the affected shoulder is generally encouraged.