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Adhesive capsulitis (frozen shoulder)

What is the Adhesive Capsulitis?

This is the terminology given to the condition where the shoulder generally becomes very tight and movements are reduced along with pain and stiffness. This is one of the common shoulder problem occurring in the middle age. It is seen in 1 in 50 population.

What causes it?

Though the condition is common, it has not yet been identified the exact reason why some get it. The risk factors for developing this condition are as follows - Diabetes, Thyroid imbalance, Parkinson’s disease and Cardiac disease, Post surgery or Post fracture around shoulder and Prolonged immobilization.

What are the symptoms/effects?

It has a long course and more commonly seen in those having Diabetes and those who smoke cigarette. This condition has been figured out to have three phases and the total duration of these phases can last up to 2 years. The three stages are as follows.

Freezing Phase: Due to increasing severity of pain, the shoulder loses range of movement. This could last from 6 weeks to 9 months.

Frozen phase: The pain actually improves but leftover with inability to move the shoulder effectively. This period can last for 4 to 6 months.

Thawing phase: Range of movement starts improving and people start gaining function, This could last for another six months to sometimes even upto 2 years.

How is it diagnosed?

Diagnosis is by thorough physical examination and investigations. The investigations such as X ray and MRI are essentially normal. These investigations are done in order to exclude other possible diagnosis.

What are the treatment options?

Frozen shoulder probably would get better over time. But this could take up to 3 years. It is essential to start some exercises in order to get movements. Anti inflammatory medications and injection into the shoulder joint with steroid can give short-term moderate relief.

Stretching, Massaging and Range of motion exercises under the supervision of a trained physiotherapist will be much useful in the management of this condition

Those who do not improve with physiotherapy a surgical procedure called Arthroscopic capsular release with manipulation of shoulder can improve the condition. After surgery, all of them need physiotherapy to preserve the range of motion that was acquired during surgery. The total recovery of the condition could be as long as 6 months despite having a surgery.