Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, and grows together with abnormal bands of tissue, called adhesions, greatly restricting motion and causing chronic pain.

Frozen Shoulder or Periarthritis of shoulder is a common condition in the decade 50 to 60 years. The shoulder joint becomes painful and stiff (frozen). Most of the patients get better with rest and analgesics and then are advised to undergo exercise program.

Movement of the shoulder is severely restricted. Pain is usually constant, worse at night, when the weather is colder, and along with the restricted movement can make even small tasks impossible. Certain movements can cause sudden onset of tremendous pain and cramping that can last several minutes.

This condition, for which an exact cause is unknown, can last from 5 months to 3 years or more, and is thought in some cases to be caused by injury or trauma to the area. It may also appear for no apparent reason. It is also believed that it may have an autoimmune component, with the body attacking healthy tissue in the shoulder. The condition may also cause chronic inflammation. Adhesions grow between the joints and tissue, greatly restricting motion and causing a number of painful complications. There is also a lack of fluid in the joint, further restricting movement.

 
In addition to difficulty with everyday tasks, people who suffer from adhesive capsulitis usually experience problems sleeping for extended periods due to pain that is worse at night and restricted movement/positions, resulting in chronic fatigue and other complications. The condition also can lead to depression, pain and problems in the neck and back, as well as damage to the tissue surrounding the area.

There are a number of risk factors for frozen shoulder, including diabetes, stroke, accidents, lung disease, connective tissue disorders, and heart disease. The condition very rarely appears in people under 40.

Frozen shoulder in diabetic patients is generally thought to be a more troublesome condition than in the non-diabetic population.  If a diabetic patient develops frozen shoulder then the time to full recovery is often prolonged from the usual 12 month period.

Here are a few common exercises. Those who do not respond to initial therapy may be given a few injections of hydrocortisone around the shoulder. Rarely those who do not respond to any forms of standard treatment are advised to undergo shoulder arthroscopy (telescopic surgery) to break the adhesions formed inside. It is a day care surgery and does not require stitches.

Physicians have described the normal course of a frozen shoulder as having three stages:

Stage one: The "freezing" or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.

Stage two: The "frozen" or adhesive stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months.

Stage three: The "thawing" or recovery, during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.

 
Management

Management of this disorder focuses on restoring joint movement and reducing shoulder pain. Usually, it begins with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids in some and the application of heat, followed by gentle stretching exercises. These stretching exercises, which may be performed in the home with the help of a physical massage or occupational therapist, are the treatment of choice. In some cases, transcutaneous electrical nerve stimulation (TENS) with a small battery-operated unit may be used to reduce pain by blocking nerve impulses. The next step often involves one or a series of steroid injections (up to six). Treatment may be needed for several months.

If these measures are unsuccessful, the doctor may recommend manipulation of the shoulder under general anesthesia to break up the adhesions. Surgery to cut the adhesions is only necessary in some cases. Surgery to correct other problems with the shoulder may also be needed.

Here are a few standard exercises which can be done at home.

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