Adhesive Capsulitis
Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by the gradual onset of pain and stiffness in the shoulder that worsens over time, and then resolves, usually within one to three years. The hallmark of adhesive capsulitis is severe shoulder pain and limited range of motion (being unable to move your shoulder either alone or even with help). The primary emphasis of treatment is on providing relief from symptoms and enhancing range of motion in the affected shoulder. Adhesive capsulitis most commonly affects people between the ages of 40 and 60 and is more prevalent in women than in men. It affects 2-3% of the population and seriously affects quality of life.
The shoulder capsule surrounds the shoulder joint and the rotator cuff tendons. Frozen shoulder occurs when the capsule of connective tissue surrounding the shoulder joint thickens and tightens, restricting movement. Pain is usually a dull ache over the outer shoulder area and may also involves the upper arm. The condition tends to develop in three stages:
- Freezing Stage: The shoulder becomes increasingly painful, and movement begins to become limited. As the pain worsens the shoulder loses range of motion. Freezing lasts from 10 weeks to 9 months.
- Frozen Stage: Pain gradually diminishes during this stage, but restricted range of motion is predominant. As the shoulder becomes stiffer, it becomes increasingly more difficult to perform daily activities. This phase can last 4 – 12 months.
- Thawing Stage: There is minimum pain, and the range of motion slowly begins to improve. Return to normal can take up to 3 1/2 years.
Adhesive capsulitis is a disease process that causes inflammation of the synovial membranes followed by capsular fibrosis. The exact cause of frozen shoulder is not fully understood, but several factors may increase the risk:
- Immobilization: Prolonged immobility or reduced mobility of the shoulder, such as after surgery or an injury, can increase the risk of developing frozen shoulder.
- Systemic Conditions: Frozen shoulder is more common in people with diabetes. These patients also suffer a greater degree of stiffness and a longer time before thawing. Other diseases that predispose to frozen shoulder include hypothyroidism and hyperthyroidism, Parkinson’s disease and cardiovascular disease.
Dr. Kaplan will review your medical history and inquire about your symptoms. He will perform a physical examination carefully moving the shoulder in all directions to determine the limitations and whether movement causes pain. He will ask you to move your shoulder and compare your range of motion in the affected shoulder with the unaffected shoulder. In both cases, if you have adhesive capsulitis, you will have limited range of motion. Dr. Kaplan may order X-rays to identify other shoulder problems and order an MRI to view images of the soft tissues and identify any other shoulder injuries.
Schedule a shoulder consultation
When you or a loved one has shoulder pain, contact Dr. Daniel J. Kaplan at NYU Langone Brooklyn office to schedule a consultation. He is a shoulder expert and can diagnose your problem and offer the best treatment options for your condition. Dr. Daniel Kaplan is a fellowship-trained orthopedic surgeon who specializes in sports medicine and shoulder surgery. He is also the chief of sports medicine at Bellevue Hospital and the chief of sports medicine at the VA hospital in Manhattan His expertise is in minimally invasive arthroscopic and advanced open reconstruction procedures. Dr. Kaplan has the experience and expertise to diagnose and determine the optimal treatment for painful shoulder.
At a Glance
Dr. Daniel Kaplan
- Fellowship-trained Sports Medicine and Shoulder Surgeon
- Expertise in Complex Shoulder Hip and Knee minimally-invasive reconstruction procedures
- Assistant Professor of Orthopedic Surgery at NYU
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