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Adhesive Capsulitis


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 causes adhesive capsulitis?

The cause of your adhesive capsulitis may not be known. The condition may be related to a previous injury or surgery. You may be more likely to develop adhesive capsulitis if:

  • You are aged 40 or older.
  • You are female.
  • You are not able to do physical activity.
  • You have medical conditions, 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: This is called the freezing or painful stage and may last 2 to 6 months. You may have increasing pain and stiffness. You may have pain with movement and at rest. The pain is often worse at night.
  • Stage 2: This is called the adhesive stage and may last 4 to 6 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: This is the recovery stage and may last from 1 month to more than 3 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 will check your neck and shoulder. He will check how your shoulder moves and how strong it is. He may move your arm in different positions while you stand or lie down. You may also need the following:

  • Plain x-ray: This test takes pictures of the bones and tissues inside your shoulder. An x-ray may show if your shoulder pain and stiffness is from another medical problem.
  • 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.
  • Magnetic resonance imaging: This test is called an MRI. During the MRI, pictures are taken of the bones and tissues inside your shoulder. An MRI may show if your shoulder joint capsule has narrowed. You will need to lie still during this test. Never enter the MRI room with any metal objects. This can cause serious injury.

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:

  • Medicines:
    • Pain medicine: You may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you take your medicine.
    • NSAIDs: This group of medicine includes aspirin and ibuprofen. It helps decrease pain. This medicine can be bought without a doctor's order. Always read the medicine label and follow the directions. NSAIDs can cause stomach bleeding or kidney problems if they are not taken correctly.
    • Steroids: This 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 under anesthesia: You are given medicine that makes you sleep. Your shoulder is then gently moved by your healthcare provider. Manipulation releases tightness in your shoulder and improves movement. This procedure may be done if other treatments do not help.
  • Surgery: Tissues in your shoulder may be cut 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 my adhesive capsulitis?

  • Stretches: Your healthcare provider may suggest stretches to help improve your symptoms. Ask your healthcare provider or your physical therapist which stretches are best and how to do them. The following stretches may be suggested:
    • 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.
    • 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.
    • 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.
  • Ice or heat: Ice or heat on your shoulder may help decrease your pain and improve shoulder movement. Apply ice to help ease pain after stretching. Put heat on your shoulder to help relax your muscles. Use ice or heat as directed.

When should I contact my healthcare provider?

Contact your healthcare provider if:

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

When should I seek immediate care?

Seek care immediately if:

  • You have new or more trouble moving your arm.

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.

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