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What is adhesive capsulitis?
Adhesive capsulitis is commonly called frozen shoulder. This occurs when the joints in your shoulder are inflamed. The inflammation leads to scar tissue. This prevents you from being able to move your shoulder in all directions without pain. Your shoulder can become stiff, and it may be difficult for you to move it at all.
Symptoms of adhesive capsulitis
The primary symptom is difficulty moving your shoulder without pain and stiffness. You may feel this when you:
- Reach up toward the sky with both arms.
- Reach your arms out straight in front of you.
- Raise your arms out to the sides of your body.
- Pretend that you are trying to unzip the back of your dress or pull your wallet from the back pocket of your pants.
At first, your shoulder may ache and feel stiff. Then it may get very painful. This is called the painful stage. It may last about 3 to 8 months. The second stage is called the adhesive stage. You may not have as much pain. However, your shoulder keeps getting stiffer. This stage usually lasts about 4 to 12 months. By the time you reach the final stage, it becomes very hard to move your shoulder, even a little bit. This stage usually lasts about 1 to 3 months. However, it isn’t very painful. Eventually, the stiffness slowly goes away. You can move your shoulder again. You may not get the full movement of your shoulder back. As your shoulder movement increases, you may still have pain at times. However, you should be able to do more activities.
What causes adhesive capsulitis?
This condition develops when the tissue in your shoulder joint tightens and restricts movement. This occurs when you are not active because of another injury, such as a rotator cuff injury, broken arm, or recovering from a surgery. Also, it happens when you use your shoulder the wrong way. Certain risks factors can increase frozen shoulder. Risks are higher for:
- people 40 years of age and older
- people with diabetes
- people with thyroid problems
- people experiencing hormonal changes (more likely during menopause)
- people who have had open-heart surgery
- people with cervical disk disease of the neck.
How is adhesive capsulitis diagnosed?
Your doctor may be able diagnose frozen shoulder just by talking to you about your symptoms and watching you move your shoulder. During an exam, your doctor may press on parts of your shoulder to see what might be causing the pain. Your doctor may also want to take an X-ray or do a magnetic resonance imaging (MRI) scan of your shoulder to look for other problems.
Can adhesive capsulitis be prevented or avoided?
Frozen shoulder can’t be prevented or avoided. However, you can reduce your risks. A person with diabetes can reduce the risk of diabetes-related illness by following his or her doctor’s lifestyle and prescription medicine advice. If you are having surgery, see a physical therapist and follow his or her post-surgery shoulder exercises. If you have any shoulder discomfort, see your doctor earlier rather than later. This may prevent serious pain and damage.
Adhesive capsulitis treatment
Your doctor can teach you physical therapy exercises to help break up the scar tissue in your shoulder. They may refer you to a physical therapist to show you how to do the exercises. Many of the exercises can be done at home.
Sometimes the exercises hurt. Your doctor may give you something for the pain or to relax your muscles. This might include over-the-counter, anti-inflammatory medications and/or steroid injections in your shoulder. Putting a heating pad or an ice pack on your shoulder for a few minutes before you do the exercise may help. Remember to warm up for 5 to 10 minutes before starting your exercises. Warm up by doing very gentle exercises and small movements with your shoulder. Warm up and stretch other parts of your body (neck, back, hands, and elbows), too.
Treating the underlying reason for frozen shoulder might be necessary. Surgery may be required if other treatments are not effective. The surgical procedure is called shoulder arthroscopy. It removes scar tissue. The surgery is done under anesthesia. That means medicine is injected into your vein prior to surgery to make you sleep and numb to pain. Arthroscopic surgery can also be used to cut the tight ligaments from the scar tissue.
Living with adhesive capsulitis
Living with frozen shoulder requires planning and maybe pain medicine. For example, you may have to avoid certain tasks or movement that you know will cause you shoulder pain. You may have to do daily physical therapy exercises. And you may have to follow your doctor’s advice for over-the-counter and prescription medicine.
Questions to ask your doctor
- How do I know if my shoulder pain is temporary or frozen shoulder?
- Can the pain be reversed with medicine and exercise?
- Does hormone replacement therapy help reduce the risk to women?
- Is it possible that my symptoms could return?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.