Adhesive Capsulitis (Frozen Shoulder)
by dr kalman piper
What Is It?
What Causes Adhesive Capsulitis?
How Long Does Frozen Shoulder Last?
- Stage one: The “freezing” or painful stage.
- Duration: between 6 weeks and 9 months.
- Slow onset of pain
- As the pain worsens, the shoulder loses motion.
- Stage two: The “frozen” stage
- Duration: 4 – 9 months
- Slow improvement in pain
- Stiffness remains.
- Stage three: The “thawing” or recovery stage.
- Duration: 5 – 26 months.
- Shoulder motion slowly returns toward normal.
How Is It Treated?
- Pain relieving and anti-inflammatory medication.
- Injection of local anaesthetic and corticosteroid.
- Injections of local anaesthetic and corticosteroid (a powerful anti-inflammatory) into the joint can help reduce pain, but usually does not affect the shoulder stiffness.
- Surgical synovectomy and capsule release.
- Surgery involves removing the inflamed tissue from inside the shoulder joint and releasing the contractures around the shoulder joint. Surgery is not recommended while the shoulder is painful, but can help recover range of motion after the painful phase has finished.
- Adhesive capsulitis can recur after a surgical release.
- Surgery is usually indicated if there is delayed recovery in shoulder range of motion.
- Physiotherapy is not useful for the shoulder while it is very painful, but should be commenced as soon as the pain starts to settle.
Key Features of Adhesive Capsulitis
- The cause is unknown.
- There is a strong association with diabetes.
- Adhesive capsulitis can take 2 – 3 years to recover.
- Treatment options include:
- Physiotherapy (after the painful (active) phase is complete).
- Surgical capsule release (after the painful (active) phase is complete).
- Surgery results are unpredictable and the frozen shoulder can recur.