Frozen Shoulder or Adhesive Capsulitis
“Adhesive capsulitis (also known as frozen shoulder) is a painful and disabling disorder of unclear cause in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain. Pain is usually constant, worse at night, and with cold weather. Certain movements or bumps can provoke episodes of tremendous pain and cramping. The condition is thought to be caused by injury or trauma to the area and may have an autoimmune component.” In Wikipedia.
What is a frozen shoulder?
This is a term we use to describe the tightening of the innermost ligaments in the shoulder. Due to inflammation, the ligaments get very tight and contracted. Think of it as putting on a really tight shirt and trying to move your shoulder around. The textbooks state that it happens without a cause, but it is more common in diabetics, patients with thyroid problems and in other medical conditions.
It is important to be aware of this so that we can possibly diagnose an underlying condition you may not even know you have. It affects women and men equally. I tend to see it in patients in their fifth and sixth decades of life. It can be common in women who are experiencing menopause.
The patients usually present with a painful and stiff shoulder. Movement of the shoulder HURTS. Most of the patients have usually been to see a therapist and have not improved.
What is the treatment for a frozen shoulder?
Treatment is in the form of medication to decrease the inflammation in the shoulder and stretch the tight ligaments with physical therapy. The normal course is for the shoulder to initially get very painful and stiff and over time loosen up. Without proper treatment, this can take a year to a year and a half to improve. With the proper treatment one can greatly reduce the time with this painful condition. Over 90% of the patients do very well with conservative treatment. Those who do not respond favorably may be candidates for a surgical release of the tight ligaments. This is done in the operating room. I can either break up the contractures manually with a gentle manipulation, or it can be done with an arthroscope. Each individual is different so check with me if you have specific questions.
It will be very important for you to start physical therapy right after the scar tissue has been released. You will begin therapy the day after the procedure and continue it for at least 6 weeks. I have specific postoperative rehab protocols which we will use. I work with the best physical therapists in Austin and the surrounding area. Having a good therapist is imperative for good post operative success. Let us help you find the right therapist for you.