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Adhesive Capsulitis (Frozen Shoulder)

A condition of the shoulder that results in pain and loss of the ability to move the shoulder in all directions.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Frozen Shoulder

If you have what is known as frozen shoulder, your shoulder gradually becomes painful and stiff without there being any clear cause. It most commonly affects people around the age of 50.

Symptoms

Frozen shoulder starts out very gradually. The pain is usually only mild at first, but becomes more severe over the course of a few months and often makes it hard to sleep. It then becomes increasingly difficult to lift your arm up or move it backwards. Over time the shoulder can become so stiff that it is nearly impossible to move, as if "frozen" in place. The medical term for frozen shoulder is "adhesive capsulitis."

Causes

Joints connect the different bones in our bodies. In the shoulder joint, the rounded end of the bone in the upper arm (humerus) fits into a socket in the shoulder blade (scapula). This "ball and socket joint" is surrounded by a strong fibrous membrane called the joint capsule.

In frozen shoulder, scar-like adhesions form in the joint capsule, causing it to thicken. Inflammations are believed to play a major role here, but it is not entirely clear what happens. In most cases no underlying cause is found for frozen shoulder. In rare cases it may develop following an accident, an inflammation or immobilization of the shoulder joint, for example after surgery. It is then referred to as "secondary" frozen shoulder...
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What works? Research summarized

Evidence reviews

Arthrographic distension for adhesive capsulitis (frozen shoulder)

‐ May improve pain at three weeks.

Oral steroids for shoulder pain (adhesive capsulitis)

There is silver level evidence (www.cochranemsk.org) that oral steroids may work to treat shoulder pain (adhesive capsulitis) in the short term. Oral steroids may decrease pain and disability, and may improve movement in the shoulder in the short term. But the benefits of oral steroids may not last 6 weeks. Oral steroids taken for short periods in people who are otherwise healthy may not cause harms. There is not enough evidence to be certain of the benefits and harms of oral steroids and more research is needed.

Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections.

Bibliographic details: Griesser MJ, Harris JD, Campbell JE, Jones GL.  Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. Journal of Bone and Joint Surgery. American volume 2011; 93(18): 1727-173321938377

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Summaries for consumers

Arthrographic distension for adhesive capsulitis (frozen shoulder)

‐ May improve pain at three weeks.

Oral steroids for shoulder pain (adhesive capsulitis)

There is silver level evidence (www.cochranemsk.org) that oral steroids may work to treat shoulder pain (adhesive capsulitis) in the short term. Oral steroids may decrease pain and disability, and may improve movement in the shoulder in the short term. But the benefits of oral steroids may not last 6 weeks. Oral steroids taken for short periods in people who are otherwise healthy may not cause harms. There is not enough evidence to be certain of the benefits and harms of oral steroids and more research is needed.

Manual therapy and exercise for frozen shoulder (adhesive capsulitis)

Frozen shoulder is a common cause of shoulder pain and stiffness. The pain and stiffness can last up to two to three years before going away, and in the early stages it can be very painful.

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Terms to know

Adhesions in the Shoulder
In frozen shoulder, the shoulder capsule thickens, swells, and tightens due to bands of scar tissue (adhesions) that have formed inside the capsule. As a result, there is less room in the joint for the humerus, making movement of the shoulder stiff and painful.
Bursitis
Inflammation or irritation of a bursa, the fibrous sac that acts as a cushion between moving structures of bones, muscles, tendons or skin.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Joint Capsule
Dense fibrous connective tissue sealing the joint. It is attached to the bones and provides stability.

More about Adhesive Capsulitis

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Other terms to know: See all 4
Adhesions in the Shoulder, Bursitis, Inflammation

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