By Ashley Brown, DPT
Physical Therapist, Tulsa Bone & Joint Sand Springs
Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by shoulder pain and loss of shoulder range of motion. People with adhesive capsulitis often complain of aching shoulder pain at rest, inability to reach overhead or out to the side, difficulty lying on the painful side, and disturbed sleep. Adhesive capsulitis can significantly affect an individual’s ability to get dressed, groom, and perform other activities of daily living.
Are you at risk?
Women and men can both develop adhesive capsulitis; however, women between the ages of 45 and 60 years with a prior history of adhesive capsulitis in the opposite arm are at a higher risk. Adhesive capsulitis is more prevalent in people with diabetes and thyroid disease. Other risk factors include a history of prolonged immobilization, trauma, and autoimmune disease.
The Four Stages of Adhesive Capsulitis
Adhesive capsulitis is classified into four stages. In the first stage, the individual will experience a sharp pain with end ranges of motion, disturbed sleep, aching pain at rest, and loss of external rotation (rotating to the side). The first stage can last up to 3 months. The second stage, lasting 3-9 months, is known as the painful or freezing stage, and is characterized by severe shoulder pain causing gradual gross loss of shoulder range of motion. The third stage can last up to 9-15 months and is known as the frozen stage. The fourth and last stage can last up to 15 to 24 months and is known as the thawing stage. During the last stage, pain improves; however, shoulder stiffness continues.
How is it diagnosed?
A physician diagnoses adhesive capsulitis through physical examination and patient history. Imaging, although not always necessary, can be used to rule out other shoulder problems.
How is it treated?
Treatment typically consists of a combination of physical therapy, nonsteroidal anti-inflammatory drugs, and intra-articular corticosteroid injections. Combination of intra-articular corticosteroid injections and shoulder mobility and stretching have shown to be more effective in improving shoulder range of motion and decreasing pain in the short term compared to exercise alone. If treated conservatively, individuals have been shown to have improved shoulder range of motion and decreased pain.
Treatment typically consists of a combination of physical therapy, nonsteroidal anti-inflammatory drugs, and intra-articular corticosteroid injections. Combination of intra-articular corticosteroid injections and shoulder mobility and stretching have shown to be more effective in improving shoulder range of motion and decreasing pain in the short term compared to exercise alone. If treated conservatively, individuals have been shown to have improved shoulder range of motion and decreased pain. If left untreated, individuals may experience decreased pain and return to performing activities of daily living within 3 years.
How can physical therapy help?
A physical therapist will perform a thorough examination and evaluation to create a personalized plan to help you meet your goals and restore function. A physical therapist will use a combination of manual therapy, exercises, stretches, and modalities to help restore shoulder range of motion and manage pain to get you back to dressing, grooming, sleeping, and performing activities of daily living. Physical therapists are great at teaching you exercises as part of a personalized home exercise program catered to your specific needs to help with your recovery. As movement specialists, physical therapists can effectively help you throughout your recovery process to meet your goals.
To make a physical therapy appointment, click here or call 918-392-1400.
