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  • Spine Disease
    • Disc Herniation (Lumbar, Cervical)
    • Spondylolisthesis
    • Degenerative Disc Disease
    • Spinal Stenosis (Lumbar, Cervical)
    • Forward Head Posture (FHP)
  • Pain Disease
    • Shingles & Intercostal Neuralgia
    • Carpal Tunnel Syndrome
    • Plantar Fasciitis
    • Coccydynia (Tailbone Pain)
    • Ischial Bursitis
  • Joint Disease
    • Osteoarthritis (Degenerative Arthritis)
    • Knee Cartilage Injury
    • Pes Anserine Bursitis
    • Adhesive Capsulitis (Frozen Shoulder)
    • Rotator Cuff Tear

Adhesive Capsulitis (Frozen Shoulder)

Background

Frozen shoulder is a condition characterized by stiffness in the shoulder; the general term is often confused with adhesive capsulitis, a specific medical condition. Adhesive capsulitis is characterized by chronic pain and motion loss in the shoulder joint, especially in both active and passive shoulder motion.

Symptoms

Symptoms include gradual increase of dull pain in the shoulder joint that may or may not accompany a mild injury, as well as restrictions in shoulder motion. In the case of idiopathic adhesive capsulitis(if the cause is unknown), the symptoms are commonly found in patients of ages 50 or older and experience similar symptoms of other shoulder joint injuries such as acute headaches, night pains, and restrictions in shoulder motion.
Lying down on the back for a prolonged period of time will increase pain and discomfort, causing problems in sleeping with night pains.
However, above symptoms of night pains are not unique to adhesive capsulitis, but rather experienced by patients of any shoulder injury.
Gradual increase in joint motion restrictions including forward flexion, abduction, and internal/external rotations will cause difficulty in performing daily activities.
Patients with frozen shoulder experience acute pains while engaging in various angles of passive motions but rotator cuff(located inside deltoid muscle and comprised of supraspinatus, infraspinatus, teres minor, subscapularis muscles that stabilize motion in shoulder) injury is accompanied by pain while engaging in specific motions.
The restriction in passive motions causes difficulty in activities such as such as combing hair, washing one’s face, or reaching for an object in an overhead shelf.
Early stage of frozen shoulder symptoms resemble closely to that of rotator cuff injury, yet if the symptoms continue to persist for an extended period or when extreme contracture occurs, motion will be limited to scapular and thoracic region only. Without movement in the upper arm (glenohumoral) joint, such may result in involuntary jerky movements or spasticity.

Causes

Frozen shoulder, coined by Codman in 1934, is a common condition that occurs in 2% of general population. Codman recorded that the condition was difficult to define, to treat, or identify the causes. Neviasier(1949) later recorded the condition as adhesive capsulitis, but the mechanism and the treatment are still unclear to this day. Some state that frozen shoulder should not be considered a diagnosis but as a symptom, and secondary frozen shoulder accompanying a clear etiological cause should be disregarded

Diagnosis

Adhesive capsulitis should be diagnosed with extensive medical examination of the shoulder by means of X-ray or MRI. Shoulder pains may also indicate herniation in cervical disc, thus the neck region should also be examined.