People often walk into the OPDs complaining about, pain in the arm at night while sleeping or its difficult for me to comb my hair or wear my vest etc. On assessing your doctor might tell you that you are suffering from adhesive capsulitis. What is Adhesive capsulitis? Adhesive capsulitis is also known as frozen shoulder, it is a condition in which the movement of the shoulder become limited. This happens because the connective tissue i.e., the joint capsule around the shoulder becomes thick, stiff and inflamed. Lack of use of shoulder often causes the shoulder capsule to thicken and becomes tight.
Although the cause remains unclear, it can be classified as primary or secondary. Frozen shoulder is primary if the onset is idiopathic while secondary results from a known cause or a surgical event. Three subcategories of secondary frozen shoulder include systemic (diabetes mellitus, and other metabolic disorders), extrinsic (cardiopulmonary disease, cervical disc,CVA, humerus fractures, Parkinson’s disease), and intrinsic factors (rotator cuff pathologies, biceps tendinopathy, calcific tendinopathy, AC joint arthiritis).
Patients presenting with adhesive capsulitis often report an insidious onset with a progressive increase in pain and a gradual decrease in active and passive range of motion. It is a self limiting disease with symptom resolution as early as 6 months upto 11 years.
It progresses through three overlapping clinical phases:
Some conditions can present with similar impairments and should be included in the differential diagnosis. These include, but are not limited to, osteoarthiritis, acute calcific bursitis/tendinitis, rotator cuff pathologies, rotator cuff pathologies, parsonage- Turner syndrome, a locked posterior dislocation of a proximal humeral fracture.
Treatment usually involves pain relief methods until initial phase passes. If the problem persists, therapy and surgery may be needed to regain motion if it doesn’t return on its own.
Some simple treatments include:
You can do the exercises given below at home whenever you get such symptoms, but you should always visit an expert physiotherapist whenever the symptoms flare up or there is no improvement
Here are some exercises which can be done at home
The key to the recovery for the frozen shoulder patients is proper stretching, mobilization of the joint and exercises performed by the physiotherapists.
There are various advanced techniques available these days which gives a better and complete recovery from the ailment. As compared to with the conventional and traditional treatments which are available with most of the therapist, these new techniques give the best results in the long run.
In these treatments, we work on the muscles and fascia. Basically, whenever there is pain, inflammation, injury, postural imbalance, due to overstretching or over-contraction etc. result in taught band formation known as trigger points. These points are basically reducing the length of the muscle which impairs the joint function and ROM. Every muscle has a trigger point patter. We are working on the faulty biomechanics by releasing these trigger points. Releasing the trigger points results restoring the normal biomechanics, with normal ROM and joint function.
These techniques include: