Adhesive Capsulitis: Causes, Symptoms, and Treatment

The medical name for a frozen shoulder, “adhesive capsulitis”, usually leaves people with one question, “what is adhesive capsulitis?”. Well, what is adhesive capsulitis? While the name itself might not bring up much in your mind, this condition affects between 2 to 5% of the population in the US. The condition is more common women and in adults in the age group of 40 and 60 years. In adhesive capsulitis, the glenohumeral joint, which is the ball and socket type of joint in the shoulder, gets inflamed and tender. With the shoulder joint becoming stiff, the normal 90 degree extension of the arms to the sides become difficult.

What Causes Adhesive Capsulitis?

In many cases, the causes of frozen shoulder are unknown although people who are sedentary and do not move their shoulder or arms for a long time are more prone to the condition. When the cause of adhesive capsulitis is unknown or idiopathic, it is classified as primary adhesive capsulitis. Under secondary adhesive capsulitis there are three subcategories that include metabolic conditions, external and intrinsic factors.

External factors include fractures and cervical disc conditions, heart disease or Parkinson’s. Metabolic conditions like diabetes are one of the common causes of adhesive capsulitis. Intrinsic factors include other shoulder conditions including arthritis, tendonitis, rotator cuff tear or sprains, or calcific tendonitis.

What is Adhesive Capsulitis and It’s Symptoms?

The main symptom is shoulder pain that is gradual in onset and progressive. Difficulty in performing tasks such as combing hair, dressing and fastening buttons behind the back are the other major symptoms.

The symptoms usually resolve anywhere between six months to one year. Sometimes, when there are other conditions present, the symptoms may linger or get worse. The three phases of frozen shoulder symptoms are described as below:

Acute phase: In the acute phase, there is gradually increasing shoulder pain at rest and the pain can be worse at night resulting in sleep interruptions. Moving the shoulder may bring on sharp pain.
Frozen phase: In this phase, the pain subsides but there is increasing loss of motion.
Thawing phase: The thawing phase is marked by progressive and spontaneous recovery with restoration of range of motion that could take between one to three years.

Treatment For Adhesive Capsulitis

Analgesics along with hot and cold packs application relieve symptoms that are mild. Early diagnosis and intervention is crucial for avoiding complete loss of motion. Physical therapy exercises are effective in reducing the stiffness and improving flexibility.

Codman exercises, also called pendulum exercises, involve passive swinging of each arm and “climbing the wall” and are some great exercises that can be done at home to both prevent recurrence and for rehabilitation. Supervised physical therapy sessions are some other treatment options. Studies have shown that physical therapy is effective in resolving the symptoms of adhesive capsulitis in 89.5% of patients.

Stretching exercises done for one to five seconds multiple times in a day are found to be effective in reducing pain and improving flexibility. A pulley is also sometimes used to assist in achieving better range of motion depending on tolerance levels of the patient.

Besides pendulum exercises, other core exercises can include supine passive forward elevation and external rotation when the arm is held at 40 degrees. Non-steroidal anti-inflammatory drugs corticosteroid injections are also given to treat moderate to severe pain and stiffness.

Arthroscopic surgery is usually the last resort when no other treatment modality has been effective in reducing the symptoms. If you’re worried or curious of the symptoms you’re experiencing, take time to set up a time to see a shoulder specialist and give your body proper attention and care!

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