When That Shoulder Aches Too Much to Move

When That Shoulder Aches Too Much to Move
Treatment options for stiff and painful shoulders caused by adhesive capsulitis

Adhesive capsulitis, sometimes described as “frozen shoulder,” is a condition where the connective tissue around the shoulder joint becomes chronically inflamed, causing thickening and tightening in the affected joint. Diagnosing adhesive capsulitis can be difficult because its symptoms—restricted movement and considerable pain—are similar to a variety of shoulder-related musculoskeletal conditions, including arthritis. Proper diagnosis of adhesive capsulitis may require extensive investigation into the patient’s medical history to eliminate other causes.

“Frozen shoulder, or adhesive capsulitis, is a common condition that can occur in many adults.  It is essentially tightening and inflammation of the lining or capsule of the shoulder which can result in pain and loss of motion.   It can take a prolonged time to improve but the majority of patients improve and can return to normal function without surgery.  Treatment usually begins with a set of stretching exercises to loosen the inflamed capsule.   Sometimes a cortisone injection into the shoulder can also help.   In resistant cases, surgery can be offered which can be done arthroscopically to resect any adhesions that cause tightening of the capsule and resulting motion loss and pain.  However, the majority of the time surgery is not necessary,” according to orthopaedic surgeon Joseph F. Scordino, MD.

According to Dr. Scordino, “Restricted loss of motion can also occur from arthritis of the shoulder.  However, arthritis has a typical appearance on x ray and in addition is usually associated with grinding or crepitus with motion.”

Adhesive capsulitis is not necessarily the result of an injury. The condition can start out as some soreness in the shoulder before the patient begins to notice some progressive restriction of movement.

Common adhesive capsulitis symptoms include:

  • Night pain, and patients typically cannot sleep on the affected side.
  • Restricted movement to the extent that patients tend to have difficulty dressing, combing their hair, or reaching into a back pocket.
  • Many patients have minimal or no pain once the shoulder gets fairly restrictive in motion, but will notice pain when suddenly reaching beyond the limits of the stiffness.

Populations most at-risk:

  • Women between ages 40 and 60 are most prone to develop adhesive capsulitis.
  • People with diabetes have an increased risk of developing the condition.
  • Persons with less physically active occupations than in persons who perform manual labor—usually the non-dominant shoulder is the one involved.

Managing pain/restoring shoulder movement:
The best way to help restore the patient’s range of movement and significantly reduce shoulder discomfort begins with gentle, progressive stretching exercises over weeks, sometimes months, in order to relieve adhesive capsulitis symptoms.

On June 5th, 2012, posted in: Latest News by
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