Adhesive capsulitis is a condition associated with the shoulder. It is also known as frozen shoulder. The indications for the onset of adhesive capsulitis include difficulty in performing day to day activities involving the shoulder. The articulations associated with the shoulder are complex comprising three joints and four groups of muscles which facilitate the movement of the shoulder in various directions. The range of motion of the shoulder is taken into consideration to identify the underlying cause for the onset of adhesive capsulitis. Adhesive capsulitis is also defined as the idiopathic painful restriction of the shoulder. This condition results in the global restriction of the muscles associated with glenohumeral joint. Adhesive capsulitis predominantly occurs in people belonging to the age group of 40-60. Women are prone to adhesive capsulitis than men. Adhesive capsulitis usually lasts for a period of two years and gradually subsides.
Clinical manifestations of Adhesive capsulitis
Adhesive capsulitis occurs in three stages. The first stage is called as the freezing stage where the patient experiences mild pain and discomfort with movements of the shoulder. Increased pain during sleep and muscle spasms are more predominant in this stage. The freezing stage usually occurs for a period of three to four months.
The second stage is called the adhesive or the frozen stage, in which the pain is reduced but movement of the shoulder is restricted to a greater extent leading to stiffness. The second stage is the most difficult stage which can last up to nine months and it involves the restriction of shoulder movements in many angles causing discomfort.
The third stage is the recovery stage or the thawing stage in which the movement is restored only to a certain degree but the patient continues to experience mild pain and movement restriction in certain angles of rotation.
Diagnosis of Frozen Shoulder
The predominant risk groups who are susceptible to adhesive capsulitis are patients who have underlying conditions such as diabetes, Parkinson's disease, hypothyroidism and cardiac conditions. Women are more prone to adhesive capsulitis than men. Patients who have a history associated with injuries or trauma pertaining to the shoulder may experience adhesive capsulitis.
Adhesive capsulitis diagnosis is more symptom-associated than radiological determination. X-rays and MRI do not play a significant role in identifying this condition as it is associated with muscle groups of the shoulder. The common symptoms through which the diagnosis of this condition is done is through the movements pertaining to the shoulder such as ability to reach and touch the back of the shoulder, reaching to the back pocket and also to reach behind the head. The exact cause for the occurrence of adhesive capsulitis is not known. In some cases young people experience this condition without any associated risk factors.
Treatment of Frozen Shoulder
Adhesive capsulitis can be treated upon early discovery of the condition. Patients suffering from frozen shoulder are usually treated by physical therapy for a few months followed by anti-inflammatory medication to relieve pain and restore motion. The primary objective during the physiotherapy is to strengthen the muscle groups of the shoulder to enable movement in various angles. Surgical intervention is done in case of intense pain and loss of movement.
Shoulder arthroscopy is done followed by physiotherapy to restore the motion of the shoulder. In the surgical procedure, the movement of shoulder is rectified by removing the scar tissue under anaesthesia. The range of motion associated with the shoulder is analyzed as a post-operative measure to ensure the accuracy of the procedure. Physiotherapy increases the shoulder movements by strengthening the internal muscles of the shoulder. Patients are also advised to follow few shoulder stretches and exercise patterns to prevent relapse of the respective condition.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 5, 2020