Frozen shoulder
- Frozen shoulder = adhesive capsulitis of the shoulder (= periarthritis of the shoulder)
- = inflammation of the joint capsule which shrinks it and makes movement painful
- Can be idiopathic (primary) or secondary to diabetes, thyroid disease, etc.
- Pathomechanism
- Inflammation of the joint capsule makes movement of the shoulder painful
- Pain causes the shoulder to be less frequently used
- Lack of use and inflammation causes the shoulder capsule to thicken and adhere to itself and the humerus -> the symptoms become progressively worse
- In the “end-stage” adhesive capsulitis the shoulder cannot be moved at all -> frozen shoulder
- Stages
- Freezing stage – pain and limited motion
- Frozen stage (frozen shoulder) – less pain, no motion
- Thawing stage – symptoms improve
- Clinical features
- Restricted and painful movements of shoulder
- Especially internal and external rotation
- Restricted and painful movements of shoulder
- Diagnosis
- Adhesive capsulitis is a clinical diagnosis based on decreased movement without underlying disease
- Negative X-ray
- MRI may show soft tissue inflammation
- Treatment
- It’s usually self-limiting
- Conservative
- NSAIDs
- Physiotherapy
- Surgical
- Manipulation under anaesthesia (MUA)
- (Not so much used anymore)
- Manipulation under anaesthesia (MUA)