Adhesive capsulitis (AC), often termed ‘frozen shoulder’, is a disease where the shoulder capsule forms scar tissue or adhesions across the joint causing stiffness, pain and dysfunction.
Adhesive capsulitis (AC), often termed ‘frozen shoulder’, is a disease where the shoulder capsule forms scar tissue or adhesions across the joint causing stiffness, pain and dysfunction. It affects between 2-5% of the population and as much as 11-20% of diabetic patients. The purpose of this article is to briefly review AC and then discuss hydrodilation and the evidence supporting its use.Generally, the cause of AC is unknown or idiopathic without a clear inciting event.
Risk factors for developing it include caucasian, female gender, age 40-60s. Systemic diseases such as diabetes mellitus, hyperlipidemia, hypertension, and thyroid dysfunction also increase your risk. A history of trauma or immobilization following surgery can also lead to AC.
Propionibacterium (P.) acnes has been linked to AC as a possible infective aetiology of the disease. Case Vignette You are evaluating a 45 year old white female with right shoulder pain for about 6 months. She suffers from diabetes and hypothyroidism.
Her shoulder pain has been insidious in onset without trauma or injury. At this time, she has pain and decreased range of motion affecting her activities of daily living. On exam her external rotation is asymmetric and her pain is moderate.
A) Stage I: Freezing, painful B) Stage II: Frozen, stiff C) Stage III: Global loss of ROM, extreme pain D) Stage IV: Persistent stiffness, no pain By history, the onset is usually insidious with a slow onset. As many as 90% of patients develop shoulder pain before restrictions in range of motion. On physical exam, external rotation is most commonly affected.
If you are experiencing symptoms that may be related to capsular distension for adhesive capsulitis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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