What is frozen shoulder (adhesive capsulitis)?
Adhesive capsulitis, also known as a ‘frozen shoulder’, is when the capsule that surrounds your shoulder joint is affected causing a characteristic pattern of pain and stiffness. This condition occurs in 3 distinct phases:
- The initial stage (known as the ‘freezing phase’) is where your joint becomes increasingly painful and stiff, and can last from 3 to 9 months
- The following stage (the ‘frozen phase’) is mainly characterised by universal stiffness throughout the joint and you get a severely reduced range of movement and can last anywhere up to 1 year
- The final stage of this condition (also called the ‘thawing phase’) is where your joint capsule begins to loosen and allow more freedom of movement. This can take 1-2 years
What causes frozen shoulder (adhesive capsulitis)?
The main underlying cause of adhesive capsulitis is not known, but it is associated with the following:
- Previous shoulder injuries that have caused you to keep your shoulder still for a long time
- Being female
- Being over 40
- Other medical conditions such as diabetes
How is frozen shoulder (adhesive capsulitis) diagnosed?
Frozen shoulder is primarily diagnosed during a medical consultation with a physical examination of the joint. Imaging such as x-ray, ultrasound or an MRI can also be used to confirm the diagnosis and rule out any other causes of your shoulder pain and/or stiffness.
Treatment and recovery
Generally, frozen shoulder (adhesive capsulitis) will get better on its own without the need for medical treatment, however this can take up to several years and symptoms can be debilitating during this time.
Pain and particularly stiffness can be relieved with anti-inflammatory and pain-killing medications as well as stretching, physiotherapy and ultrasound-guided injections, which can help to free up the joint and restore some movement.
Surgery can be used in cases where symptoms are causing severe limitations.
Arthroscopic capsular release
Arthroscopic capsular release is a keyhole (arthroscopic) surgery which involves the release of the tight capsule seen in frozen shoulder. During this procedure, the arthroscope (camera) is inserted into the shoulder and fluid (saline) is passed into the shoulder to allow the surgeon to look within the shoulder joint. The surgeon then uses small instruments to release the capsule where it has tightened up the most and therefore releasing it.
Following the procedure you will be reviewed regularly by your surgeon and you will follow a rehabilitation program for 6 to 12 weeks. Your arm will be resting in a sling for approximately 24 hours after surgery. This is for comfort only and is not there to stop you moving your arm. You need to move your arm as soon as possible to get the most out of your shoulder after the operation. It is quite normal to experience aching, discomfort after your exercises but be guided by your level of discomfort.
Depending on the nature of your employment, you may be signed off from work for two to six weeks.
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