Frozen Shoulder

Typical appearance of adhesive capsulitis or frozen shoulder intraoperatively. A small arthroscope is in the front of a left shoulder, looking posteriorly (towards the back).

So any patient that has seen me has gotten my standard frozen shoulder talk: there is a capsular ballon between your muscles and your bones that supports the ball and socket type joint.  In frozen shoulder, also known as adhesive capsulitis (which if you take about the name adhesive = sticky, capsule = shoulder capsule, itis = in medicine we use the suffix “itis” to denote inflammation; so you have a sticky shoulder capsule that is inflamed), this capsule contracts and becomes inflamed and usually appears red and almost angry.  This will classically limit range of motion activities both actively (how much you can raise or rotate your arm) and passively (how much your friend or examining provider can move or rotate your arm).

The most common question I get, which is rather frustrating to answer, is why? And why me?  This falls into the category of so called idiopathic disease, in the sense that like much of medicine, we do not understand why this occurs.  However, I commonly tell my patients that women, caucasians, history of autoimmune disease (thyroid or diabetes etc), and Northern European descent increases the prevalence of this condition.  A great Ortho blog that I am getting involved with, Orthobuzz, just put up a great synopsis of the genetics of this and mentioned a meta-analysis performed which analyzed over 5,000 papers.  You can read more here.

However, this one paragraph really drives home the point for me:

The results were fascinating. One study, involving 1828 twin pairs, showed an 11.6% prevalence and demonstrated a heritability of 42% for frozen shoulder after adjusting for age. In a second study, involving 273 patients, 20% of patients with frozen shoulder had a positive family history involving a first-degree relative. A third study, involving 87 patients, showed that 29% of patients with frozen shoulder had a first-degree relative with this condition.

Frozen Shoulder Surgery

Frozen Shoulder capsule being cut with a VAPR wand

Frozen Shoulder – Treatment

If you have a frozen shoulder, do not hesitate to get in touch with our office in Seattle – locations in Ballard and Northgate for an appointment!  Please call 206-368-6100 for an appointment with Dr. Schwartz, or contact us for more information.  Surgery is rarely indicated for this disorder, as most improve with a combination of cortisone injections, physical therapy, and appropriate NSAID use.  If necessary, a simple arthroscopic surgery (a capsular release) can be quite powerful and helpful.

 

 

 

 

Frozen Shoulder from Daniel Grant Schwartz on Vimeo.