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Adhesive Capsulitis

WHAT YOU NEED TO KNOW:

What is adhesive capsulitis?

Adhesive capsulitis happens when tissues in your shoulder tighten and swell. The condition is often called frozen shoulder because the swollen tissues cause pain and decrease your shoulder movement.

What are the signs and symptoms of adhesive capsulitis?

  • Shoulder pain and stiffness that gets worse over time
  • Pain at night that wakes you
  • An ache in your shoulder even at rest but that gets worse with movement
  • Muscle spasms in your neck, shoulder joint, or near your collarbone
  • Trouble reaching over your head or behind you
  • Muscle weakness

What increases my risk for adhesive capsulitis?

  • Age 40 or older
  • Being a woman
  • Not being able to do physical activity
  • A past shoulder injury or surgery
  • A medical condition, such as diabetes, thyroid disease, or heart or lung disease

What are the signs and symptoms of adhesive capsulitis?

Adhesive capsulitis may last from several months to years before it gets better on its own. You can have adhesive capsulitis in one or both shoulders. The condition has 3 stages:

  • Stage 1 is called the freezing or painful stage and may last 2 to 9 months.
  • Stage 2 is called the adhesive stage and may last 4 to 12 months. You may have less pain. You may still have pain when you move your arm to reach. Your shoulder may still be stiff, and you may not be able to move your shoulder much.
  • Stage 3 is the recovery stage and may last from 5 months to more than 2 years. Your shoulder movement may slowly start to get better. You may also begin to have less pain.

How is adhesive capsulitis diagnosed?

Your healthcare provider will do an exam. He or she will check your neck and shoulder. He or she will check how your shoulder moves and how strong it is. Your provider may move your arm in different positions while you stand or lie down. You may also need the following:

  • X-ray or MRI pictures may be taken of the bones and tissues inside your shoulder. An x-ray may show if your shoulder pain and stiffness is from another medical problem. An MRI may show if your shoulder joint has narrowed. Never enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • A joint x-ray is a picture of the bones and tissues in your joints. You may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is adhesive capsulitis treated?

The goal of treatment is to help you regain as much shoulder movement as possible. Treatment will depend on what stage you are in. Ask your healthcare provider about these and other treatments for adhesive capsulitis:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Steroid medicine helps decrease pain and swelling. Healthcare providers may give this medicine as a shot into your shoulder.
  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.
  • Manipulation is a procedure used to move your shoulder. You will be given anesthesia to make you sleep through this procedure. Manipulation releases tightness in your shoulder and improves movement.
  • Surgery may be used to cut the tissues in your shoulder to release the tightness. During surgery, swollen or damaged tissue may also be removed. Surgery may be needed if other treatments do not help.

How can I help manage adhesive capsulitis?

  • Stretches:
    • Doorway stretch: Stand in a doorway with your painful arm bent at the elbow. Place your hand on the door frame and turn your body away from the door frame. Hold this position for 30 seconds. Relax and repeat.
      Shoulder Flexion Stretch
    • Forward stretch: Lie on your back with your legs straight out. Use your healthy arm to push your painful arm up over your head until you feel a gentle stretch. Hold this position for 15 seconds. Slowly lower your arm to the starting position. Relax and repeat.
      Arm Stretches Lying 1
      Arm Stretches Lying 2
    • Crossover stretch: Use your healthy arm to gently pull your painful arm across your chest just below your chin. Pull until you feel a gentle stretch. Hold this position for 30 seconds. Relax and repeat.
      Crossover Arm Stretch
  • Apply ice as directed. Ice helps decrease pain and swelling. Apply ice to help ease pain after stretching. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your shoulder. Apply ice for 15 to 20 minutes every hour, or as directed.
  • Apply heat as directed. Heat helps relax muscles and may help improve shoulder movement. Use a heat pack, or soak a small towel in warm water. Wring out the extra water before you apply the towel to your shoulder. Apply heat for 20 to 30 minutes every hour, or as directed.

When should I seek immediate care?

  • You have new or increased trouble moving your arm.

When should I contact my healthcare provider?

  • You have worse pain and stiffness in your shoulder.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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