Frozen shoulder – A stubborn condition|
Frozen shoulder or Adhesive Capsulitis is an inflammatory contraction of the glenohumoral joint (shoulder joint) capsule. This often leads to pain and decreased range of motion of the shoulder. It can be a painful and prolonged condition. Most recovery times are very lengthy.1
2 % to 5 % of the population is affected by frozen shoulder. This condition commonly affects women, usually between the ages on 40-60 years.1,2,3 Poor movement and sedentary lifestyle increase the risk of frozen shoulder. People that are diagnosed with endocrine disorders such as diabetes, thyroid disease and autoimmune disease are also at higher risk. Other risk factors include prolonged immobilisation, chest surgery, heart disease, mastectomy and nerve damage in the neck.1,2,3,4 People with poor posture that have an increased thoracic kyphosis (large curve/hump in the mid back) are also more prone.5
There are 3 stages of adhesive capsulitis, which can develop from 2 months to 2 years.1,3,6
Stage 1 (freezing/painful stage): Symptoms progress and range of motion becomes more restricted. There is progressive, involuntary stiffness.
Stage 2 (frozen/transitional stage): There is decreasing range of motion and pain may not worsen and also does not occur at the end of this stage.
Stage 3 (thawing stage): Range of motion begins to improve and there is an eventual return of shoulder movement.
Most people that suffer from frozen shoulder will find loss in muscle strength and flexibility in the shoulder joint. Hence, management and treatment will involve lots of strength exercises and stretches. Heat pools and shoulder movements help with this. Frozen shoulder rehabilitation programs are quite aggressive – meaning that there is a lot of work to do for the patient to get better. It is common that patients compliance and motivation waiver and may not allow the joint to ‘thaw’ properly.
In terms of treatments, several studies have found that physical therapy exercises, as well as mobilization, are able to decrease pain, improve range of motion and function significantly.2 Moist heat and gentle manipulation were also effective in improving the symptoms of frozen shoulder.3 It has also been found in certain studies that pain-free, gentle, stretching exercises were more effective than intensive and painful exercises.7 Such forms of treatment, as mentioned above, are used by chiropractors to help patients with shoulder disorders such as frozen shoulders. Therefore, it is highly recommended to see a chiropractor for shoulder disorders as they are trained to provide the most effective treatment for their patients with frozen shoulders.8
To find out more information on frozen shoulder/ adhesive capsulitis, please contact us or seek your allied health professional.
- Chiang J, Dugan J. Adhesive capsulitis. J Am Acad Physician Assist. 2016;29(6):58-9. doi: 10.1097/01.JAA.0000482308.78810.c1
- Neviaser A, Stupay K. Management of adhesive capsulitis. Orthop Res Rev. 2015;2015:83-94. doi: http://0-dx.doi.org.prospero.murdoch.edu.au/10.2147/ORR.S56317
- Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg. 2011;20(3):502-14. doi:10.1016/j.jse.2010.08.023
- Ebaugh D, Spinelli B, Schmitz KH. Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Med Hypotheses. 2011;77(4):481-7. doi:10.1016/j.mehy.2011.06.015
- Salvo AG. Mosby’s Pathology for Massage Therapists [e-book]. 2nd ed. St. Louis, Mo: Mosby; 2008 [2016 Jul 30]. Available from: https://books.google.com.sg/books?isbn=0323291589
- Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008;1(3):180-9. doi: 10.1007/s12178-008-9031-6
- Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther [serial on the Internet]. 2010 [2016 Jul 30];5(4):266-73. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096148/
- Brantingham JW, Cassa TK, Bonnefin D, Jensen M, Globe G, Hicks M, et al. Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review. J Manipulative Physiol Ther. 2011;34(5):314-46. doi:10.1016/j.jmpt.2011.04.002
Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should contact your own physician or other qualified health can provider with any questions you may have regarding your condition. Do not disregard professional medical advice or delay seeking it based on information from this content. Relying on information provided by this content is done at your own risk. Although the authors have made every effort to provide the most up-to-date evidence-based health information, this content should not necessarily be considered the standard of care and may not reflect individual practices in other geographic locations.