Last week at my preceptorship I saw a patient diagnosed with adhesive capsulitis. The patient was confused at the fact that he had severely limited mobility without recent trauma. Adhesive capsulitis, which is more commonly known as frozen shoulder, involves stiffness and pain in the shoulder joint.
Frozen shoulder occurs when the joint capsule thickens and tightens around the shoulder joint, restricting its movement. The risk factors of frozen shoulder include individuals (especially women) 40 and older, individuals who have reduced mobility due to a stroke, rotator cuff injury, or broken arm, and individuals with a systemic disease such as diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease and Parkinson’s disease.
Frozen shoulder typically develops slowly in three stages. The freezing stage is the first stage in which any movement of the shoulder causes pain, and the shoulder’s ability to move becomes limited. This stage can last 2-9 months. The frozen stage is the second stage in which pain may decrease, but the shoulder increasingly becomes more stiff. This stage lasts from 4-12 months. The last and final stage is the thawing stage in which the shoulder’s ability to move begins to improve. This stage lasts from 5-24 months. Usually within 1-3 years symptoms improve.
Treatment involves range-of-motion exercises to obtain greater mobility, and may involve corticosteroids and numbing medications injected directly into the joint. In rare and severe cases arthroscopic surgery is necessary to loosen the joint capsule. As future chiropractic physicians, we can be instrumental in the care of adhesive capsulitis by introducing range-of-motion exercises as well as by mobilization techniques.