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    Frozen Shoulder

    What is a Frozen Shoulder?

    Adhesive capsulitis (AC) or frozen shoulder is an insidious inflammatory condition of the shoulder that causes fibrosis of the joint capsule and persists for more than 3 months. It is accompanied by gradually progressive stiffness and significant restriction of range of motion, especially external rotation.

    Females are 4 times more often affected than men, while the non-dominant shoulder is more prone to be affected.

    Causes

    The cause of the frozen shoulder is not yet fully understood. However, some possible risk factors have been identified:

    • Diabetes mellitus
    • Stroke
    • Thyroid disorder
    • Shoulder injury
    • Dupuytren disease
    • Parkinson disease
    • Complex regional pain syndrome

    Staging

    There is gradual restriction of passive shoulder motion which progresses through 3 overlapping phases:

    • Freezing (2 to 9 months): initial, painful phase with predominant pain that is worse at night, with gradually increased glenohumeral joint ROM restriction.
    • Frozen (4 to 12 months): stiffness and persisted glenohumeral joint motion limitation, but with less pain than that at the "Freezing" stage.
    • Thawing (12 to 42 months): recovery phase with the gradual return of range of motion.

    Signs and Symptoms

    Patients present with following symptoms:

    • Sudden onset of unilateral anterior shoulder pain.
    • Passive and active range of motion restriction, first affecting external rotation and later abduction of the shoulder.
    • Functional impairments include limited reaching, particularly during overhead (e.g., hanging clothes) or to-the-side (e.g., fasten one's seat belt) activities.
    • Restricted shoulder rotations result in difficulties in personal hygiene, clothing and brushing hair.
    • Neck pain can occur due to overuse of cervical muscles as a compensation for the loss of shoulder motion.

    In general, depending on the stage and severity, the condition is self-limiting, interfering with activities of daily living, work, and leisure activities.

    Diagnosis

    Diagnosis is done with the help of a physical examination, but some imaging tests such as X-rays, ultrasound, or MRI may also be advised to rule out other conditions.

    Management

    Management includes physical therapy for strengthening and improving the range of motion.

    Warning: Above information provided is an overview of the disease, we strongly recommend a doctor's consultation to prevent further advancement of disease and/or development of complications.

    Disclaimer: The information provided herein on request, is not to be taken as a replacement for medical advice or diagnosis or treatment of any medical condition. DO NOT SELF MEDICATE. PLEASE CONSULT YOUR PHYSICIAN FOR PROPER DIAGNOSIS AND PRESCRIPTION.

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