Frozen Shoulder (Adhesive capsulitis)
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. The connective tissue surrounding the joint becomes stiff and inflamed greatly restricting movement.
The primary cause of frozen shoulder is unknown although it has been associated with conditions such as diabetes, cervical disc disease, trauma and immobilisation. It generally occurs in people over the age of 40 years and is more common in women aged 40 to 65 years. Frozen shoulder is also more common in sedentary workers than in labourers.
Frozen shoulder is a self limiting condition that can take up to 2 years to resolve.
This condition involves 3 distinct phases:
- Freezing Phase is an acute inflammatory phase which lasts 2 to 9 months. Patients get pain at rest and with activity, as well as pain at night. There is significant loss of motion.
- Frozen Phase with progressive stiffness lasting 3 to 12 months.
- Thawing phase with decreasing pain and increasing motion. This can last 12 to 24 months.
Treatment
Management of frozen shoulder is aimed at controlling pain and maintaining mobility of the shoulder joint. It is important to use the arm within pain free limits and to not immobilise the arm as this will cause the condition to deteriorate.
Chiropractic treatment is aimed at gently maintaining motion through the shoulder joint. Gentle stretching exercises performed within a pain free range can help to reduce further stiffness. In a small percentage of patients conservative treatment is not successful and surgical intervention may be required. This may include manipulation under anaesthetic or arthroscopic surgery to loosen the joint capsule.
