Adhesive Capsulitis
Written by Robert A Wilson   
Thursday, 15 February 2007

A frozen shoulder literally means a “stuck” joint. Normally, the shoulder joint moves easily, similar to a ball and socket. A capsule (connective tissue) around the shoulder joint allows the joint to move freely. Any injury or inflammatory conditions like bursitis or tendonitis can produce adhesions (scar tissue) on the joint capsule that covers the shoulder joint. Eventually, this scarring prevents movement. Sometimes, a frozen shoulder can develop after an arm has been immobilized for an extended period of time. Risk factors include a sedentary lifestyle; poor blood circulation as in diabetes and peripheral vascular disease; delayed treatment of shoulder injuries or inflammatory conditions; and prolonged immobilization of the joint.

Symptoms may include:

In the beginning:

  • Mild discomfort and stiffness in the shoulder
  • Pain with movement
  • Reduced range of motion

Advanced problems:

  • Pain that radiates to the neck and arm
  • Severe pain
  • Restricted movement
  • Pain that interferes with daily activities and wakes you from deep sleep

What your doctor can do:

  • Diagnose the injury by asking about your symptoms, doing a physical exam, and ordering shoulder x-rays.
  • Rule out other diseases or conditions like arthritis or bone fractures (breaks).
  • Prescribe medicines to reduce pain and steroids or non-steroidal anti-inflammatory drugs to reduce inflammation.
  • Inject steroid medications directly into the joint or bursa (sac containing a lubricant that coats joint) to reduce inflammation.
  • Recommend physical therapy to exercise and stretch the joint capsule.
  • Manipulate the shoulder joint externally or recommend surgery to remove the adhesions.

What you can do:

  • Apply ice and/or heat (hot compresses or a moist heating pad) to the site for 15-20 minutes every hour as directed by your doctor.
  • Complete stretching exercises at home 1-2 times per day. Wear an arm sling for support.
  • Take acetaminophen (Tylenol), ibuprofen (Advil, Motrin, Nuprin) or naproxen (Aleve) for minor discomfort.
  • Keep scheduled appointments with your physical therapist for additional treatments like ultrasound therapy, electrical stimulation, and hot/cold therapies.

What you can expect:

Most people recover within a few months; other may take longer depending on the severity of the condition.
Complications may include permanent dysfunction of the shoulder joint, chronic pain, and atrophy (breakdown) of the joint capsule.

Contact your doctor if you develop symptoms of a frozen shoulder. DO NOT delay treatment!

Last Updated ( Friday, 08 February 2008 )