What is frozen shoulder/adhesive capsulitis?

Adhesive capsulitis, or ‘frozen shoulder’ is a condition that affects the flexible capsule surrounding the shoulder joint. Frozen shoulder progresses through three stages.

1.     The first stage is the painful ‘freezing’ stage that includes extreme pain and progressive loss of shoulder range of motion. This stage can last for several weeks to months.  

2.     The second stage is characterized by freezing of the capsule and dramatic loss of shoulder movement. This stage lasts for several months to years due to the progressive thickening and adhesions surrounding the shoulder.

3.     The final stage is known as the ‘thawing’ stage where we can expect diminishing pain and improved mobility. This stage may last up to nine months.

What causes frozen shoulder?

Adhesive capsulitis may be classified as ‘primary’ or ‘secondary’. Primary adhesive capsulitis is of unidentifiable cause. Secondary adhesive capsulitis usually follows some type of injury or inflammation to the shoulder joint. With pain comes lack of movement, which may lead to thickening of the capsule and a frozen shoulder.

Who does it usually affect?

Adhesive capsulitis is most common in the 40-65-year-old population. Females are affected more frequently than men. Asians have a 3.6 times greater risk for developing this condition and could be due to the increased prevalence of diabetes or thyroid disease in that population. It appears that if you have previously experienced adhesive capsulitis in the opposite arm, you at greater risk of experiencing it again.

How should your shoulder feel?

 Your range of motion will be most limited with reaching overhead, behind your back, or to the side. Sometimes this can pose a challenge for grooming and dressing. You may feel a grinding or popping when you move your shoulder. Be sure to tell your doctor if you notice fever, night sweats, excessive thirst, excessive urination, nausea, chest pain/ pressure, or shortness of breath.

How to treat frozen shoulder

There are many treatment options that is able to breakdown the capsular adhesions and increase the flexibility of the shoulder. With the use of acupuncture, shockwave therapy, and chiropractic adjustments, we are able to help you return to normal. It is important that you understand that this condition improves very slowly. Be patient with your recovery. Some patients can require several months to regain function, while a minority of patients report permanent stiffness. If needed, you may apply heat to your shoulder for 15-20 minutes at a time at home.

Key Takeaway Points

 Adhesive capsulitis is a condition that affects the shoulder capsule and requires multiple months to years to resolve. It typically affects 40-65-year-old females with a history of diabetes or thyroid disease. You should notice a painful stage, freezing stage, and thawing stage. Difficulty moving your shoulder with tremendous amounts of pain is typical. Treatment of frozen shoulder is typically conservative with the aid of manual therapy, acupuncture, shockwave therapy, exercises, and manual manipulation.

Check out what Harvard Medical School has to say about adhesive capsulitis

https://www.health.harvard.edu/shoulders/frozen-shoulder

Harvard Medical School also recommends specific stretches and exercises for adhesive capsulitis

https://www.health.harvard.edu/shoulders/stretching-exercises-frozen-shoulder