Frozen shoulder or Adhesive capsulitis

What is frozen shoulder?

Frozen shoulder, or adhesive capsulitis, is a condition that causes pain and limits the shoulder’s movement.

It happens when the connective tissue around the shoulder joint (the shoulder joint capsule) gets thick, stiff, and swollen. (The joint capsule has attachments that connect the top of the upper arm bone [humeral head] to the shoulder socket [glenoid], keeping the joint stable. This is also called the “ball and socket” joint.)

The shoulder is “frozen” because the more it hurts, the less it is used. Not using it makes the shoulder capsule tighter and thicker, making the shoulder harder to move.

Who are the risk factors of frozen shoulder?

Age: Usually affects adults between 40 and 60 years old.

Gender: Women get it more often than men.

Recent shoulder injury: Any injury or surgery that makes the shoulder immobile (for example, by using a brace, sling, wrap, etc.). Injury may be a rotator cuff tear or a broken shoulder blade, collarbone, or upper arm.

Diabetes: Frozen shoulder happens to 10 to 20 percent of people with diabetes mellitus.

Other health problems: These include stroke, low or high thyroid levels, Parkinson’s disease and heart disease. Stroke can limit arm and shoulder movement and cause frozen shoulder. It is not very clear how other health problems affect frozen shoulder.

What happens in frozen shoulder?

Frozen shoulder has three stages of symptoms:

• The “freezing” stage: The shoulder gets stiff and hurts to move. The pain gets worse over time. It may be worse at night. The shoulder is harder to move. This stage takes 6 weeks to 9 months.

• The “frozen” stage: The pain may get better, but the shoulder stays stiff. This makes daily life harder. This stage takes 2 to 6 months.

• The “thawing” (recovery) stage: The pain gets better, and the shoulder moves more easily. The shoulder gets back to normal or almost normal. This stage takes 6 months to 2 years.

What are the treatment options for frozen shoulder?

'To relieve pain, we can try some simple methods until the first stage is over. If the problem does not go away, we may need Pain interventions to move your shoulder again. In rare cases, surgery may be needed.

Some easy treatments are:

• Hot and cold packs. These can lower pain and swelling.

• Medicines that help with pain and swelling. These are nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen.

• Physical therapy. A physical therapist shows you stretching and range of motion exercises. Home exercise program. Keep doing the exercises at home.

• Transcutaneous electrical nerve stimulation (TENS). A small device that runs on batteries and blocks pain signals

Pain procedures:

• Shoulder Intra articular Interventions under ultrasound guidance

  • Hydro-dissection

  • Steroid injection

  • Hyaluronic acid or growth factor injection

• Manipulation under anesthesia

Dr. Chinmoy Roy is a well known pain expert and author of multiple medical books who is available at Rajarhat Pain Clinic, Newtown, Kolkata. He is an expert of using radiofrequency, CRYO, chemical neurolytics and other modalities related to the pain procedures. You can always contact him for treatment of Frozen Shoulder.