ADHESIVE CAPSULITIS / FROZEN SHOULDER

Classic Presentationfrozen_shoulder.jpg

The presentation for frozen shoulder varies depending on the stage at which the patient presents.  The patient is usually over age 40 years.  In the acute phase, the patient complains of moderate to severe pain that limits all shoulder movement.  In most instances, the patient cannot recall any specific event that triggered the pain.  The pain interferes with sleep, and in many instances causes the patient to seek prescribed pain medication.  In the middle pahse, the patient may present with a past history of the acute phase 1 to 3 months previously; now the pain is much less, but he/she notices that lifting the arm or turning it out is severely restricted.  In the final phase, the patient may report a very slow increase in range of motion, but he/she still has significant reduction.

Cause

The cause is currently unknown.  The most accepted theory is that adhesion development occurs between or within the capsule of the shoulder; however, this is not always visible at surgery.  Also, the patient often responds to stretching techniques that place little stretch on the capsule.  Some individuals may be predisposed, such as those with diabetes, hyperthyroidism, or chronic obstructive or other lung diseases, and those who have had a myocardial infarction.  It has been shown that contrary to logic, this process is not due to immobilization.

Treatment

Manipulation Under Anesthesia has emerged after multiple studies as the safest and most effective treatment for Frozen Shoulder.

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