The shoulder joint is surrounded by connective tissue called the capsule. Sometimes, the capsule can become thickened and inflamed, making the tissue more rigid and tight around the shoulder joint. This problem is called adhesive capsulitis, or frozen shoulder.
Although there is not one direct cause of frozen shoulder, this condition is more common in adults, women over 40 years of age, diabetics, and patients with thyroid disorders. Frozen shoulder can also occur in patients who have their shoulder immobilized for a period of time, such as after surgery or an injury.
Symptoms of a frozen shoulder include pain, difficulty sleeping, trouble reaching arm behind your back, and general shoulder stiffness.
During physical examination of the shoulder, your medical provider will assess range of motion of both shoulders. Often times, you will have decreased range of motion on the affected shoulder, both when you attempt to move it and when he or she attempts to direct it.
Radiographs and MRIs are sometimes ordered to rule out specific causes and to identify other potential sources of shoulder symptoms.
Treatment includes anti-inflammatory medication and cortisone injections to reduce inflammation. Physical therapy is important for shoulder stretching to increase your range of motion. Frozen shoulder will often resolve over time–up to six years; however, it can be quite painful and may persist for 2-6 years. Surgical options to resolve symptoms include manipulation under anesthesia and shoulder arthroscopy. During manipulation, the doctor will move your arm to free the scar tissue and capsule. During shoulder arthroscopy, your doctor will make tiny incisions and use instruments to release the capsule. Stretching and therapy are very important after surgery to maintain motion and prevent frozen shoulder recurrence.