Frozen Shoulder (also known as Adhesive Capsulitis in sophisticated terms) is a painful musculoskeletal condition that primarily restricts the activity of shoulder joint and usually runs a chronic course. In untreated cases, symptoms may resolve spontaneously over a period of 1-3 years (1).

Clinical data indicates that poorly managed frozen shoulder can significantly alter the quality of life by compromising physical independence and capacity to perform day-to-day operations.

Symptoms of Frozen Shoulder:

The symptomatology or presentation of frozen shoulder varies according to the stage of capsulitis.

The entire course of inflammation can be divided into 3 phases; which are discussed as under:

Phase I: Pain

This phase is marked by ongoing inflammation and acute pain. The symptoms of pain and discomfort are generalized in the beginning, but tends to localize after some time (mostly in the anterio-lateral aspect of the shoulder joint and arm). Most patients experience significant exacerbation of pain after activity or movement. Other classic symptoms of this phase are:

  • Restricted range of motion due to pain
  • Stiffness of joint
  • A lot of patients also complain of sleep disturbances due to moderate to severe pain, stiffness and limited range of motion of shoulder joint
  • Inability to perform normal day to day operations such as combing your hair, brushing your teeth or putting on a shirt.

The length of this stage is highly variable and may last for a period of few weeks to a few months.

Phase II: Stiffness:

This phase is marked by resolution of pain and acute discomfort; however, most patients develops a residual stiffness that leads to limited range of motion. Consequently, affected individuals experience moderate difficulty in carrying out their professional (occupational) as well as personal tasks.

The average duration of this phase is 4 to 6 months.

Phase III: Thawing

This phase marks the slow restoration of normal physiology of shoulder joint. Affected individuals report resolution of stiffness and restricted mobility with time. No residual discomfort or pain is experienced. Moderate physical activity and stretching/ strengthening exercises are usually helpful in improving the pace of recovery. The duration of this phase is 6 to 8 months.

The management of frozen shoulder is usually conservative. Most cases responds fairly well to physical therapy and holistic methods of care (such as stretching exercises, massage therapy) or more sophisticated procedures like Trigenics (also referred to as OAT procedure)

References:

  1. Brand, R. A. (2008). Loss of scapulohumeral motion (frozen shoulder). Clinical Orthopaedics and Related Research®, 466(3), 552-560.