The shoulder is a unique anatomical structure with an extraordinary range of motion (ROM) that allows us to interact with our environment. A loss of mobility of this joint will cause significant morbidity. Adhesive capsulitis is a poorly understood musculoskeletal condition that can be disabling. Adhesive capsulitis is diagnosed by numerous physical characteristics including a thickening of the synovial capsule, adhesions within the subacromial or subdeltoid bursa, adhesions to the biceps tendon, and/or obliteration of the axillary fold secondary to adhesions.
Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely. Treatment for frozen shoulder usually starts with nonsteroidal anti-inflammatory drugs (NSAIDs) and application of heat to the affected area, followed by gentle stretching. Ice and medicines (including corticosteroid injections) may also be used to reduce pain and swelling. And physical therapy can help increase your range of motion. A frozen shoulder can take a year or more to get better. If treatment is not helping, surgery is sometimes done to loosen some of the tight tissues around the shoulder. Two surgeries are often done. In one surgery, called manipulation under anesthesia, you are put to sleep and then your arm is moved into positions that stretch the tight tissue. The other surgery uses an arthroscope to cut through tight tissues and scar tissue.
The prevalence of frozen shoulder is estimated to be 2 to 5 percent of the general population . The condition is most common in the fifth and sixth decades of life, with the peak age in the mid-50s. Onset before the age of 40 is rare. Women are more often affected than men. The non-dominant shoulder is slightly more likely to be affected. In 6 to 17 percent of patients, the other shoulder becomes affected within five years.