Adhesive Capsulitis Or Frozen Shoulder: Everything You Need To Know

Adhesive capsulitis, also known as frozen shoulder, is defined as the progressive loss of passive shoulder mobility. This loss of mobility is accompanied by a diffuse pain that predominates in the anterolateral area of ​​the shoulder.

Several authors have described possible causes and pathological changes that occur in the glenohumeral joint capsule and surrounding tissues. Its course is insidious, progressive and, in most cases, self-limiting.

This injury most often occurs in people between 40 and 70 years of age. In addition, it is more common in women and patients who have changes in the thyroid gland or diabetes.

As we will see later, the goal of treatment is to restore joint mobility and functionality. There is also a focus on reducing pain through the administration of medication or, ultimately, surgery.

shoulder anatomy

The shoulder is where the arm meets the rest of the body. It is the articulation with the greatest variety of movements in the human body. It is a joint formed by joining the ends of the 3 bones:

• Clavicle.
• Shoulder blade.
• Humerus.

These three bones are connected by muscles, ligaments and tendons, which allow them to move. The main shoulder joint connects the head of the humerus to the scapula.

This joint is called the scapulohumeral joint. It has two articular surfaces; one of them corresponds to the head of the humerus, which has a hemispherical shape, and the other is the glenoid cavity of the scapula. Both surfaces are covered with cartilage, which allows for painless and fluid movement.

The set of muscles and tendons attached to the surfaces of bones makes, as we have seen, the mobility of the joint. We have, for example, the rotator cuff, made up of four muscles that provide mobility and stability to the shoulder.

Causes of Adhesive Capsulitis

Several authors have suggested that the etiology of this lesion is autoimmune. However, serological tests do not confirm this theory. Others suggest that it is a variant of reflex sympathetic dystrophy. This theory was not fully accepted either, since, being a dystrophy, adhesive capsulitis does not improve.

De Palma, another specialist, said that the main cause of the onset of this lesion is muscle inactivity. Causes of lack of scapulohumeral mobility include:

• Biceps tenosynovitis.

• Calcareous tendinitis.
• Contusions.
• Fractures.
• Capsular scars secondary to injuries or surgical procedures.

Adhesive capsulitis treatment

As we mentioned at the beginning of the article, the goal of treatment is to restore shoulder mobility and functionality.

In addition, various medications, such as anti-inflammatory drugs or steroids, can be administered to soothe the pain caused by the injury. In more severe cases, the patient may undergo arthroscopy.

As this pathology has two very marked phases, one in which pain predominates and the other that causes stiffness, physical therapy treatment is different.

During the first phase, the pain is very severe and appears even when the patient is at rest. Therefore, treatment will aim to manage this pain and ensure that the patient achieves maximum range of motion in the shoulder joint.

As the patient improves in this regard, treatment will focus on the goal of increasing joint reach. In addition, exercises that include the rotator cuff are also started, as it is involved with the joint capsule.

Last but not least, the patient should be informed that other parts of the body may be affected by the frozen shoulder problem, as pain is felt and mobility is reduced, it is normal to try to compensate with other muscles.

Thus, pain in the neck or lower back may arise, due to the stress that the tissues in these areas receive when making incorrect movements.

Conclusion

Adhesive capsulitis or frozen shoulder is an injury that occurs, as its name suggests, in the shoulder joint. When it occurs, this joint loses mobility and functionality considerably, in addition to causing pain that can be very intense.

Consult a professional about the most recommended treatments for your situation, as well as any questions you may have about this painful injury.