Adhesive capsulitis (frozen shoulder) is the result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the “ball” part of the ball and socket joint. Frozen shoulder dramatically reduces the range of motion of the affected joint. It severely impacts one’s ability to carry out their daily activities. A frozen shoulder may/may associate with shoulder pain and tenderness. Though affecting all movements, lifting the arm to the side is often the most impaired movement of the shoulder.
Conditions
Tendinitis, bursitis, and rotator cuff injury can lead to adhesive capsulitis. Especially if the person refuses to move the shoulder for an extended amount of time. Diabetes, chronic inflammatory arthritis (such as rheumatoid) of the shoulder, and chest or breast surgery are known risk factors for adhesive capsulitis.
The condition is diagnosed following a review of the patient’s history for prior trauma caused by overreaching/lifting or repetitive movements. The examination will look for severe loss of shoulder range of motion (ROM), both active and passive. X-rays, blood tests for underlying illnesses, and other imaging approaches may also be required to make a final determination for frozen shoulder.
Shoulder Treatment
Treatment for adhesive capsulitis has classically included an aggressive combination of anti-inflammatory medications, cortisone injections, manual therapies (such as joint manipulation, mobilization, and traction), exercise training, ice (if painful), heat (if no pain), and physiotherapy modalities such as ultrasound, electric stimulation, laser, etc.
Exercises performed by the patient are also highly important for achieving a satisfactory outcome. The patient can begin immediately with pendulum-type exercises, long-axis traction, and eventually strengthening exercises (TheraTube, TheraBand, light weights, etc.).
A recent study involved 50 patients with frozen shoulders. 20 were males, 30 were females, ages 40-70 years. They underwent chiropractic care for a median time frame of 28 days (range: 11-51 days). Researchers looked at patient-reported pain on a 1-10 scale and their ability to raise the arm sideways (abduction). Of the 50 cases, 16 resolved completely (100%). 25 showed 75-90% improvement. 8 showed 50-75% improvement and 1 experienced less than 50% improvement.
