Is your shoulder stiff and sore? You might have had a traumatic injury, but it also might have just crept up on you?
Adhesive capsulitis, or “frozen shoulder” is a less common condition, effecting up to 5% of the population but it can be quite a debilitating condition. Pain and stiffness of the shoulder can have a huge effect on activities of daily living and impair quality of life(1). The good news is that adhesive capsulitis often involves the non-dominant arm, although both arm involvement has been reported in up to 40% to 50% of cases(2).
Adhesive capsulitis is an umbrella term for different kinds of issues that result in a stiff or painful shoulder joint. One issue is long-term low-level inflammation, related to your metabolism, or body chemistry. This is linked to age, cardiovascular health and diabetes mellitus(3). This process creates excess fibrous tissue around the shoulder joint which leads to stiffness, pain and dysfunction. Adhesive capsulitis can be divided into two categories, primary or secondary. Primary adhesive capsulitis can occur spontaneously without any specific event and is usually described as something that has crept up on a patient. Secondary adhesive capsulitis often occurs following a traumatic incident, this could include a fall, shoulder dislocation, shoulder fracture or even as a complication to shoulder surgery. While the scientific community agrees that the risk factors of adhesive capsulitis are difficult to confirm, a consistently reported finding in research is that adhesive capsulitis is age related. It is rarely seen before age 40, and in some countries, it is referred to as “fifty year old shoulder”(3). Based on this information, making a diagnosis of adhesive capsulitis often involves a more broad investigation rather than looking at just the shoulder.
If left untreated, adhesive capsulitis is a condition that can easily spiral out of control, and before you know it, arm movement can be severely restricted. On top of this, without a treatment plan it can be difficult to measure and track progress as well as know when to progress exercises.
A structured treatment plan and program can do wonders for a stiff sore shoulder. Research emphasises that physiotherapy is the first line of treatment for adhesive capsulitis. During the early stages while pain is dominant, physiotherapy will focus on mobilising the shoulder and maintaining/improving the range(4). Once pain has settled, studies have found that a tailored exercise and stretching program leads to satisfaction in 90% of patients(5).
So if you’re sick of not being able to reach the top shelf, or washing your hair has become a nightmare then now is the time to kick your shoulder into gear!
- Hard Tissue (2013), 2(5), 75-84
- Curr. Rev. Musculoskelet. Med. (2008), 1(3-4), 180-189
- Med. Hypotheses (2016), 88, 12-17
- JSES (2004), 13(5), 499-502
- J. Bone Jt. Surg. (2000), 82(10), 1398-1407