Adhesive capsulitis of the shoulder results in a stiff shoulder joint. This occurs as a result of scarring and tightening of the capsule of the shoulder joint. A tight capsule prevents the ball from rolling and moving across the socket and therefore patients with a frozen shoulder present with pain, stiffness and lack of function.
Often frozen shoulders occur as a result of minute and often unnoticed injuries to the shoulder joint which can occur after a heavy bout of overhead DIY and can occur as a result of a simple jarring to the shoulder as well. People who are diabetic are particularly prone to develop a frozen shoulder as are people who have had a heart attack, a stroke, who have had breast surgery or who have simply been put in a plaster for a wrist fracture. In the early stages of the disease the pain is quite severe and can be worse at night and often disturbs sleep. Over the course of a few months the pain tends to subside but this is replaced by increasing stiffness and lack of movement. If left alone it may take up to 2-3 years for the shoulder to loosen up but more often than not patients are left with residual joint stiffness.
If accurately diagnosed in the early stages of the disease then the pain can be controlled through painkillers and a local anaesthetic and steroid injection. This allows the Physiotherapist to help improve the range of shoulder motion and with a regular stretching programme could prevent stiffness of the joint. However, in established cases a simple local anaesthetic injection is unlikely to be beneficial. Such patients may require a manipulation under general anaesthetic along with a local anaesthetic and steroid injection followed by an intensive stretching and rehabilitation programme. In very resistant cases, particularly individuals who suffer from diabetes then an arthroscopic capsular release may be required.