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Adhesive Capsulitis (Frozen Shoulder)

Overview

Adhesive capsulitis, or frozen shoulder, is a condition in which the glenohumeral (shoulder) joint loses motion due to thickening of the joint capsule. It is characterised by pain along with a decreased range of motion during active (own movement) or passive movement (supported movement).

  • Based on severity, adhesive capsulitis is classified into three stages: freezing, frozen, and thawing. Each stage lasts for 6–9 months
  • The primary symptoms are pain and stiffness, especially during external rotation and forward elevation

  • Age 40–60 years
  • Female gender
  • Diabetes mellitus, hypothyroidism, heart diseases, kidney diseases, or autoimmune diseases

  • Assessment of the range of shoulder motion (active and passive).
  • Assessment of specific shoulder muscles.
  • Radiography (X-ray) to rule out other conditions, such as calcification (excess calcium deposition) and arthritis.
  • Magnetic resonance imaging (MRI) for confirming other associated conditions, such as a rotator cuff tear.

Non-surgical treatment

Non-surgical treatment methods aim to provide osteoarthritis care, alleviate pain, and increase the range of motion. They include:

  • Oral anti-inflammatory medications
  • Steroids (oral or local injections)
  • Ultrasound-guided nerve block (suprascapular nerve)
  • Hydrodilatation
  • Physical therapy

Surgical treatment

Surgery is rarely indicated but may be required in the frozen stage. Surgical approaches include:

  • Manipulation under anaesthesia
  • Capsular release using the arthroscopy procedure
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