Adhesive capsulitis

Adhesive capsulitis or Frozen shoulder , is the inflammation of capsule and synovial membrane of shoulder joint.

Here, the tissues around the shoulder joint become stiff due to formation of adhesions and largely restrict the joint’s range of motion.

Prevalence and risk factors
Frozen shoulder tends to occur after the age of 40. Women are more affected than men. However there are certain factors which may pose an individual at potential risk. They are:

  • Diabetes
  • Cervical disc disease
  • A ‘wrench’ or fall on the shoulder.
  • Shoulder dislocation or fracture in the arm bone.
  • Stroke
  • Hyperthyroidism
  • Heart diseases

Presentation and symptoms of frozen shoulder: whether one is suffering from frozen shoulder becomes evident with the following symptoms:
Pain :

  • A dull pain which becomes more intense over weeks.
  • Sharp pain produced at the limit of active or passive motion.
  • Gradual spreading of pain till elbow and neck.
  • Pain worsens at night.
  • Loss of movements
  • All movements are severely restricted due to pain initially and tightening of fibrous capsule later.

Muscle spasm and weakness
Muscles around the shoulder may go into a protective spasm in order to not damage themselves further. Gradually, muscle weakness may set in.
Functional loss
The person is incapacitated because of not being able to do simple tasks like reaching out to high shelves, combing hair and other daily activities.
Posture
The smaller and the bulkier muscles of shoulder become tight. Due to this the ‘gleno humeral’ rhythm of shoulder is often disturbed making the shoulder girdle held in elevation along with chin and head thrusting forwards. The patient generally adopts this posture subconsciously to give comfort to the painful shoulder.

Also, these symptoms are associated with lot of anxiety levels or depression which must be brought down before full recovery is expected.

An overview of treatment options
Capsulitis is one of the most difficult conditions to treat. The treatment should always be based on a thorough physical examination and confirmed diagnosis by X-rays, MRIs etc.

Depending upon the severity, the treatment consists of physiotherapy, corticosteroid injections, manipulation under anesthesia and surgery.


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