Thomas S. Bottiglieri, D.O.

Adhesive capsulitis, also known as Frozen Shoulder), is a condition that impacts shoulder joint motion. The joint capsule becomes inflamed, irritated, and contracted.

Adhesive capsulitis is uncommon in young people and is almost always found in patients ranging from 40-70. Those with metabolic disease such as diabetes are at greater risk.

This condition is thought to occur from inflammation of the joint capsule and synovium, resulting in the formation of adhesions within the capsule. It often follows prolonged inflammation in conditions such as bursitis and tendinitis that have been left untreated.

 Signs & Symptoms

The main symptom is pain. An inability to reach overhead, or behind one’s back due to loss of passive and active range of motion are commonly reported. When reaching overhead it is easy to see an imbalance and loss of motion as compared to the unaffected arm. An easy test to perform at home is reaching behind your back to see how far you can touch. Normally a person can reach just above their lumbar spine. With adhesive capsulitis some people will notice it is difficult to get their hand past their back pocket.

Treatments

Restoration of a normal range of motion of the shoulder joint is important. Early intervention helps.

Non-operative treatments include:

1. Non-steroidal anti-inflammatory medicines. Drugs such as ibuprofen can help with pain and swelling
2. Physical therapy and home exercise programs focus on improving range of motion
3. Joint injection with steroid can reduce inflammation
4. Hydro-dilation using a large bolus of fluid to expand the joint capsule with a standard injection techniques & ultrasound guidance can improve motion
5. Manipulation of the shoulder under anesthesia can break through adhesions

We have had excellent success with early intervention using injection, hydro-dilation, and subsequent manipulation either in the office or with sedation in the surgical suite.

Watchful waiting for this condition is a likely a mistake as it almost always progresses. If you have noticed diminishing ability to raise your arm overhead or reach behind your back, don’t wait. Get in for an evaluation ASAP to correct this painful condition and restore normal function of your shoulder.