Adhesive capsulitis, also commonly referred to as ‘frozen shoulder’, is characterized by the progressive stiffening of the shoulder capsule and surrounding ligaments leading to very limited and painful shoulder movements.

Although we are unsure of the cause of frozen shoulder, it has been noted to be more common among diabetics and people suffering from thyroid disease, and it often occurs in the non-dominant arm. It is most common in the 40-65 year age group and occurs more frequently in women than in men.

Patients with Adhesive Capsulitis often present with:

• progressive shoulder pain and decreased range of motion
• onset of pain without cause or minimal trauma
• increased pain at night and/or sharp pain with shoulder movement
• the end ranges of shoulder movement are the most painful

How long does it last?

The generally accepted time course for frozen shoulder is 12-24 months. However, it is worth noting that its duration is quite variable, some patients may experience mild symptoms that persist for years, and others may have their symptoms spontaneously resolve. 

The 3 Phases of Frozen Shoulder:

Stage I – ‘freezing phase’ (3-9 months):

• Characterized by the onset of pain with certain shoulder ranges of motion, and increased pain in the shoulder at night. 
• During this phase a frozen shoulder can mimic other types of shoulder injuries in its presentation which can lead to misdiagnosis 

Stage II – ‘frozen’ phase (9-15 months):

• Range of motion of the shoulder is lost, the shoulder joint seems to be ’frozen’.

Stage III – ‘thawing phase’ (15-24 months): 

• Progressive improvement in the range of motion of the shoulder.

Goals of treatment:

Frozen shoulder will be managed quite differently from other shoulder injuries. Addressing it early and appropriately can lead to a better prognosis for patients. Goals of treatment for this condition tend to focus on functional improvement including decreasing pain and improving range of motion. Often patients with this condition will have altered scapular movement to compensate for their painful and limited shoulder movements. This can lead to pain and dysfunction elsewhere including the neck and upper back. 

If you are wondering if you may be suffering from frozen shoulder, your chiropractor in Aylmer can help determine an appropriate diagnosis and plan of management, including addressing any areas of compensation. 

REFERENCES:

1. M et al. Frozen shoulder: The effectiveness of conservative and surgical interventions – Systematic review. British Journal of Sports Medicine 2011: 45: 49-56.
2. Kelly MJ et al. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis – Clinical Practice Guidelines. The Orthopaedic Section of the American Physical Therapy Association (APTA)
3. Kelley MJ et al. Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomized controlled study. Journal of Orthopaedic & Sports Physical Therapy 2009; 39(2): 135-148.