Adhesive capsulitis, better known as frozen shoulder, is a condition associated with shoulder pain and stiffness. It is more common in people 40–60 years of age and affects women more than men. There is a loss of the ability to move the shoulder, both voluntarily and by others, in multiple directions. The shoulder itself, however, does not generally hurt significantly when touched. Muscle loss around the shoulder may also occur. Onset is gradual, over weeks to months. Complications can include fracture of the humerus or biceps tendon rupture. Frozen shoulder often resolves over time without intervention but it may take 1–3 years to fully resolve. Pain and stiffness may not completely resolve in 20-50% of people.
The cause in most cases is unknown. The condition can also occur after injury or surgery to the shoulder. Risk factors include diabetes and thyroid disease. The underlying mechanism involves inflammation and scarring. The diagnosis is generally based on a person's symptoms and a physical exam and may be supported by an MRI.
Symptoms of Frozen Shoulder
Symptoms include shoulder pain and limited range of motion although these symptoms are common in many shoulder conditions. An important symptom of adhesive capsulitis is the severity of stiffness that often makes it nearly impossible to carry out simple arm movements. Pain due to frozen shoulder is usually dull or aching and may be worse at night and with any motion. The symptoms of primary frozen shoulder has been described as having three or four stages. Sometimes a prodromal stage is described that can be present up to three months prior to the shoulder freezing. During this stage people describe sharp pain at end ranges of motion, achy pain at rest, and sleep disturbances.
- Stage one: The "freezing" or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.
- Stage two: The "frozen" or adhesive stage is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts from four to nine months.
- Stage three: The "thawing" or recovery, when shoulder motion slowly returns toward normal. This generally lasts from 5 to 26 months.
Treatment for Frozen Shoulder
Dr. Stefanides is a board-certified orthopedic surgeon who specializes in shoulder and knee arthroscopy and shoulder reconstruction. If you feel you have symptoms of frozen shoulder, don't hesitate to contact us today and make an appointment at one of our clinics in Astoria or Bayside. Dr. Stefanides will perform a physical examination and decide which treatment is best for you.