Patients with shoulder stiffness and pain often wonder if they could be suffering from a frozen shoulder. Frozen shoulder, also known as adhesive capsulitis, is characterized by a painful, gradual loss of shoulder motion. This occurs secondary to fibrosis and contracture of the joint capsule. Usually, this problem can be diagnosed with a simple xray and careful physical exam without the need for more complex, time consuming, and expensive studies such as MRI.
Frozen shoulder occurs in 2% to 5% of the population, and a majority of patients are female. Ages commonly range from 40 to 60 years, and the non-dominant hand is more frequently involved. About 25% of those affected will develop the condition in the opposite shoulder. The exact cause is uncertain, but there are associations with diabetes, thyroid dysfunction, Dupuytrens contractors, autoimmune disease, and breast cancer treatment.
While the natural history of the condition is gradual improvement, it can take many months or even years for the problem to resolve. A recent review from the Hospital for Special Surgery (Neviaser, Hannafin 2010) covered various treatment options and found that, in well designed studies, steroid injections provided consistent, lasting improvements in motion and pain at one year compared with physical therapy alone. Surgical intervention can be done arthroscopically and has been shown to provide lasting gains in motion and pain relief compared with therapy or manipulation without surgery for those patients with prolonged (over 6 months) symptoms not responding to non-operative measures. Click here to learn more about frozen shoulder.