Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. Adhesive capsulitis is common but poorly understood. It was first described by Duplay1in 1872 as a ‘peri-arthritis scapulo-humerale’ and in 1934, Codman first used the term ‘frozen shoulder. Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is twice as common in women than in men.It can be bilateral, especially in patients with diabetes. Although it is generally considered self-limiting.No one really understands why some people develop a frozen shoulder. For some reason, the shoulder joint becomes stiff and scarred. The shoulder joint allows more motion than any other joint in the body. When a patient develops a frozen shoulder, the capsule that surrounds the shoulder joint becomes contracted. The patients form bands of scar tissue called adhesions. The contraction of the capsule and the formation of the adhesions cause the frozen shoulder to become stiff and cause movement to become painful.Several systemic conditions such as heart disease and Parkinson's disease have also been associated with an increased risk of developing a frozen shoulder.
The exact underlying cause has not yet been identified but it has been seen that there has been some underlying history of trauma at the shoulder or a weak musculature around shoulder girdle which couldn’t have been able to survive under load sharing.
Sign and symptoms
- Shoulder pain; usually a dull aching pain at rest
- Limited movement of the shoulder
- Difficulty with activities of daily living
- Pain when trying to sleep on the affected shoulder
Where pain and stiffness are present, options include manipulation under anaesthesia (MUA), arthroscopic and open release of contractures and hydrodilatation.
Pain control can be achieved with anti-inflammatory medications. These can include pills taken by mouth, such as ibuprofen, or by injection, such as corticosteroids.
- Exercise therapy:
- Shoulder muscles stretching
- Shoulder mobilisation
- Myo fascial release techniques
- Manual therapy ( MWM, Hold-relax )
- Moist heat therapy
- Tens/ IFT as required
Some studies say that electrotherapy is not more beneficial in frozen shoulder
Self exercises for the patient
- Shoulder wheel
- Codman,s exercises
- Towel stretch
- Armpit stretch
- Finger walk on the wall
Precautions to be maintained as well.