Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is a common problem affecting patients in their early forties and onwards. It can come on after even a seemingly minor injury, in many cases, in seems to just start for no apparent reason. It is slightly more common in patients who have diabetes. The symptoms start initially with a period of weeks to months of increasingly severe shoulder pain. These symptoms are particularly severe at night, affecting sleep. The pain is often worsened by sudden movements, and it may sometimes be difficult to find a comfortable position. During this period, the shoulder joint is undergoing a process of inflammation, resulting in pain.
After a period of time, the pain continues, but starts to give way to a process of scarring and stiffening of the shoulder movements, the so-called “freezing” stage. During this stage, the shoulder joint becomes increasingly restricted in its range of movements, sometimes to the point of significantly affecting activities of daily living like dressing, and reaching for items overhead.
Finally, during the “thawing” stage, the pain subsides and the shoulder gradually regains its previous motion.The entire process may take up to 18 months.
Treatment during the painful inflammatory phase is directed at controlling pain and increasing comfort. During the freezing and thawing phases, physiotherapy is used to hasten the return of useful shoulder range of motion. Occasionally, minimally invasive arthroscopic surgery may be required in patients who fail to recover their range of motion.