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Adhesive Capsulitis



Adhesive Capsulitis (frozen shoulder) is a common condition that leads to stiffness of the joint and immobilization of the shoulder joint. Conditions that must be ruled out as causes for it include shoulder arthritis, shoulder bone spurs, shoulder bursitis, shoulder rotator-cuff conditions, and impingement syndrome of the shoulder.

Causes

This condition is more likely to affect women than men, especially women over the age of 50. There is no definite reason why Adhesive Capsulitis occurs, though there may be some correlation to those who suffer from diabetes or chronic fatigue syndrome (CFS) as well as heart attack and stroke victims and people with hypothyroidism or hyperthyroidism.

Symptoms

Adhesive Capsulitis is characterized by many of the same symptoms that accompany rotator cuff problems:

  • Pain when the arm is raised
  • Muscle weakness
  • Decreased ability to use the arm

It usually causes pain as well when leaning upon or lying down on the affected shoulder.

At first the capsule of the shoulder starts to adhere to the humeral head. This tends to cause a lot of pain and some loss of shoulder motion. Commonly the pain tends to lessen after a few months.

The next step in the progression of the condition is continued loss of shoulder motion. Minimal motion results due to the increased capsular adhesion to the humerus and the increased thickening of the capsule itself. Pain can exist during this time but is usually not a major factor. The most common complaint is extreme loss of shoulder range of motion. Loss of shoulder motion may last for one or more years.

Home Treatment

Physical therapy and stretching are important for initial treatment along with anti-inflammatories .

  • Ice the Shoulder It will be helpful to ice the frozen shoulder for 15 minutes 3-4 times per day (ice for 15 minutes, off for 1 hour). Using shoulder ice packs to apply cold compression to the site and help reduce swelling.

  • Heat the Shoulder Using heat for a frozen shoulder is also very helpful. Shoulder heating pads create good blood flow to the area. The healing properties in the blood flow to the injured area and help speed healing. It is important to ice the shoulder just after the heat treatment to control the blood flow so there is not excessive swelling.
  • Take Anti-Inflammatories Ibuprofen will help decrease pain and swelling. Also there are many types of topical pain gels for the shoulder that will help reduce pain and spasm.


Shoulder Exercise

  • The first exercise that is recommended is the pendulum exercise: Bend at the waist and place your good arm against the wall to stabilize yourself. Let the affected shoulder and arm hang and become very loose. Slowly start a very small circular motion with that arm in a clockwise direction; continue to increase the circumference of the circle slowly until you are starting to reach an uncomfortable region. Don't go past this point of pain. Repeat the exercise going counterclockwise.

  • The second exercise is called wall climbing: Place the fingers of the affected arm on the lowest point of the wall that you can reach while standing straight up. Slowly crawl your fingers up the wall as far as you can until you reach your limit of no pain. With both exercises, the goal is to increase the range of motion over time.

  • Exercise against resistance: Use a rubber exercise tubing to provide resistance while you exercise the shoulder in all ranges of motion. This type of exercise will help improve shoulder strength and stability. Always exercise within a pain-free range of motion. At times you may find that only the middle portion of the range of motion is painful, yet you can exercise above and below the area of pain without discomfort. It is important to do this if you can.

  • You should always exercise a frozen shoulder within a range of motion that doesn't cause pain.

    Medical Treatment

    While a frozen shoulder may heal itself untreated within a year or so, full shoulder range of motion may never be regained. The whole freezing/frozen/thawing cycle can take a long time. Physical therapy and exercise is believed to be essential to managing this condition.

    ***The information, including opinions and recommendations, contained in the Web site is for general educational purposes only. Such information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. No one should act upon any information on this Web site without first seeking medical advice from a qualified medical physician with whom they have a confidential doctor/patient relationship.***


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