ADHESIVE CAPSULITIS

SUMMARY

1. AKA “frozen shoulder,” characterized by painful, globally restricted shoulder ROM in patients 40-60yrs of age.

3. Risk factors: DM, CVA, AMI, prolonged immobilization, trauma, inflammatory arthritis.

4. Stage 1: 1-3 mths with shoulder pain & no significant ROM restriction;
Stage 2 (freezing stage): 3-9 mths with shoulder pain & ROM restriction;
Stage 3 (frozen stage): 9-15 mths without shoulder pain & ROM restriction;
Stage 4 (thawing stage): 2 years with improvement in ROM.

5. Up to 3 intra-articular corticosteroid injections can be used during stages 1 & 2 of adhesive capsulitis to reduce inflammation & shorten the duration of this condition.

6. Postural retraining to reduce kyphotic posture, forward humeral positioning, passive joint glides, non-painful passive ROM exercises, scapular stability exercises and closed chain rotator cuff exercises.

7. If no improvement after 6 mths: capsular hydrodilatation, MUA, and arthroscopic adhesolysis should be considered.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].