Frozen shoulder, or adhesive capsulitis, is a condition affecting the shoulder more commonly in females than in males. The condition is described as a significant reduction in shoulder range of motion due to tightening of the soft tissue around the glenohumeral joint. This condition affects individuals mostly between the ages of 40-60 years old. Occurrences increase with individuals also suffering from diabetes. The condition is most commonly seen in the non-dominate arm unless trauma is involved.
The condition commonly presents itself in 4 stages:
1) Pre-adhesive stage: full or slight decrease in motion. Lifting the arm away from the body and turning the arm outward can be extremely painful.
2) Active phase: early signs of decrease in global range of motion of the joint. Global range of motion becomes painful and radiation of pain can start to present itself.
3) Freezing phase: inflammation begins to decrease, with moderate reduction in joint range of motion. This is the phase where you start to see signs of the condition on x-rays. Decrease in range of motion of the capsule itself. There seems to be less pain while the patient is not using the arm but there is still pain with range of motion.
4) Chronic Stage: this is the stage where range of motion has completely decreased. There is pain with resting and range of motion has also decreased.
What might cause the condition of frozen shoulder? The most common cause of frozen shoulder is prolonged immobilization of the shoulder. Coronary artery disease, chest surgery and mastectomy are also very common causes of this particular condition. Also, the condition can result from a motor vehicle accident. Frozen shoulder is described by patients as a gradual onset of pain which will lead to more stiffness over time. The patient will start to notice a significant decrease in the shoulder joint range of motion the further along they progress through the stages.
Management of Adhesive Capsulitis is through vigorous manual therapies 3-5 times for week until the range of motion begins to return. Chiropractic mobilization of the glenohumeral joint with associated soft tissue therapies has been very successful in treating this particular condition. The patient must be extremely dedicated to their home exercise program. Depending on how long the patient waits to seek treatment, the condition can take a year or more to resolve. It is important to seek treatment early because it can be a slow, long-term process to get back to normal shoulder function.