Adhesive Capsulitis

by Craig W. Goodhart, MD 13. February 2015 16:14

One most painful conditions experienced in the shoulder is adhesive capsulitis.  This is defined as pain and loss of motion in the shoulder, which occurs for no reason. It usually is a result of inflammation and contracture of the shoulder resulting in pain. It is oftentimes associated with diabetes, thyroid disorders, previous surgery (long and rest), prolonged immobilization and extended hospitalization.

Symptoms of adhesive capsulitis are the slow onset of pain and stiffness. There is pain within the range of motion of the shoulder specifically with internal and external rotation.

A physician following a thorough physical examination and radiographs taken of the shoulder makes the diagnosis of adhesive capsulitis. An MRI is performed to rule out other possibilities causing the capsulitis.

The treatment for adhesive capsulitis is generally non-operative. It begins with a gentle structured program of physical therapy working towards a pain-free range of motion. NSAIDs, physical therapy, and intra-articular injections are oftentimes helpful in the early treatment of adhesive capsulitis. The majority of patients will improve over time though it may take many months before pain resolves and range of motion returns to normal.

The operative treatment for adhesive capsulitis occurs only after 3-6 months of supervised medical care. Various forms of treatment are available. Most commonly an arthroscopic surgical release is performed and in some cases a simple manipulation under anesthesia. All surgery has risks and as a result this should be the last option in the treatment of the shoulder pain.

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