What is adhesive capsulitis?
Adhesive capsulitis, or as it’s more commonly known, ‘frozen shoulder’, is when the shoulder capsule swells, stiffens and restricts mobility of the shoulder joint.
What are the signs and symptoms?
Symptoms have a gradual onset and slow progression. Often patients don’t seek medical advice until the symptoms are quite advanced and their pain is severe and range of movement is quite limited.
The first stage is called the ‘painful stage’ where pain occurs in the shoulder and the range of movement becomes slight limited. The second stage is the ‘frozen stage’ where the shoulder freezes and range of motion becomes limited. The third stage is the ‘thawing stage’ where the range begins to improve again. This can often last between 12 to 42 months. Symptoms can often be worse at night, disrupting normal sleep patterns and increasing stress levels.
Who gets adhesive capsulitis?
Doctors aren’t sure why this happens to some people and not to others, although it’s more likely to occur in people who have recently experienced prolonged immobilisation of their shoulder, such as after surgery or an arm fracture, or have had some kind of injury to the shoulder such as a fall or blow. The exact cause is unknown, and often misdiagnosed.
Risk factors include age (between 40 and 70 years old), gender (female), reduced mobility, rotator cuff injury, and some systemic diseases such as diabetes, overactive thyroid (hyperthyroidism), under-active thyroid (hypothyroidism), cardiovascular disease, tuberculosis and Parkinson’s disease.
How is adhesive capsulitis treated?
Generally your GP will prescribe anti-inflammatory or cortisone medications. There is no evidence to support their effectiveness over other physical therapies. Injections of cortisone or capsule injections in order to stretch the capsule may be advised but produce varied results and can cause further pain throughout the joint and supporting structures. Surgery should only be considered after three months of non-effective conservative treatments. An arthroscope is the usual method for diagnosis and treatment. Although it is only likely to reduce the term of the pain on average by a few weeks, compared to physical therapy.
Are there any complications?
Typically there are no long-term complications of adhesive capsulitis. There is a small chance of the condition returning or presenting in the other shoulder.
What can I do to help my frozen shoulder?
1. Physical Therapy including massage
Manipulation and passive stretching of the joint, performed along side massage, can help manage pain and increase range of motion. Massage can also help manage the back and neck pain that may be associated with compensation for the limited range of the shoulder.
2. Gentle stretching exercises
Stretching the rotator cuff in all it’s directions can help increase the range of the shoulder and ease muscle tension. Be sure to not force any movement and risk further damage to the joint.
3. Heat and ice
When the shoulder is inflamed, especially after use, use ice to ease any inflammation and pain. Ten minutes at a time with an ice pack to the painful area is best. When you are resting the shoulder, use heat such as a heat cream and heat bag on the shoulder to ease muscle tension in and around the shoulder joint.
Ten to thirty minutes of relaxation techniques like meditation will help ease any heightened nerve activity that may be contributing to pain and tension in the rotator cuff. Relaxation will also help you get more from your physical therapy session, reduce your stress levels, manage the pain naturally and improve sleep quality.