Adhesive Capsulitis – Symptoms and Treatment
The shoulder joint is formed by the humerus, the scapula and the clavicle. The bones (except the clavicle) and ligaments are surrounded by strong tissues, collectively called the joint capsule. This capsule is filled with lubricating fluid, synovial fluid, that helps the shoulder bones to move easily.
Adhesive capsulitis is a condition where the shoulder does not move normally. Also known as frozen shoulder, it’s a disorder of the shoulder joint capsule. This painful condition occurs due to the thickening and tightening of the shoulder capsule and the ligaments. Tissue bands called adhesions develop and sometimes the synovial fluid present in the capsule is also insufficient, says Dr Vijay Kumar Sohanlal – a highly experienced orthopaedic surgeon. As a senior specialist in joint replacement and orthopaedics at MGM healthcare and Mahi Clinic – Chennai, he has been successfully treating patients for over a decade.
The process of frozen shoulder usually begins with pain in the shoulder. The pain increases in severe cases, especially with the movement and the patient is usually unable to sleep. In this condition, the patient is unable to move the arm up or turn it to the side.
The condition may worsen leading to loss of external rotation of the shoulder. Stiffness of the shoulder increases and it may seem to be frozen in place.
Gradually, the condition may improve restoring mobility and strength in the shoulder. However, it takes a long time to reach this stage and can take several years also.
Causes and Risks
The frozen shoulder can occur by itself. It can even follow a surgical procedure if the patient is immobilized for an extended duration. The condition of a frozen shoulder occurs more in diabetics, especially those who are insulin-dependent. Patients with Dupuytren contracture and hypothyroidism are also at a higher risk of developing the condition. Frozen shoulder tends to occur more in females, especially in their fourth decade of life.
Diagnosis and Treatment
You must consult an orthopaedic specialist if you have the above symptoms. The doctor will examine your active and passive range of motion. To check the active range of motion the doctor will ask you to move the shoulder. The doctor tries to move your shoulder to check the passive range of motion.
The condition is confirmed if there is a reduction in the active and passive range of motion. The doctor may examine the other shoulder also as there is a higher risk for the other shoulder to develop the condition. The specialist may require imaging tests, like X-ray and MRI, to confirm the reason for stiffness.
Most of the time it’s enough to have anti-inflammatory and pain-reducing medicines along with physical therapy. Your physical therapist recommends exercises to improve the range of motion of your shoulder. These may include stretching and external rotation exercises.
In some cases, the above treatment may not get the desired result and the doctor may recommend surgical intervention. The doctor will discuss the surgery and the recovery expected after the surgery. The procedure is aimed at stretching the joint capsule to remove the stiffness. The procedure increases the range of motion of your shoulder.
Shoulder arthroscopy is a procedure that requires smaller incisions through which a tiny camera is inserted to get the images of the joint. The doctor uses these images to operate on the joint. Dr Vijay informs that the procedure has a high success rate in correcting the condition and enabling recovery of the patient.