What is Frozen Shoulder?
Frozen Shoulder also known as Adhesive Capsulitis is an idiopathic condition when the shoulder joint becomes inflamed. More specifically, it includes synovitis in the glenohumeral joint, thus the connective tissue within the shoulder becomes inflamed. The cause of adhesive capsulitis is unknown at this time. However, there are some populations when this condition is more common including individuals with diabetes mellitus or thyroid disease, those who are 45-60 years old, females, and individuals with a previous occurrence of frozen shoulder in the opposite arm.
This condition often lasts for 12-18 months depending on each individual’s symptoms and pathological involvement. The progression of frozen shoulder is often broken down into four different stages including pre-adhesion, freezing, frozen, and thawing stages. The pre-adhesion phase can last 1-3 months. Individuals often describe pain at the end ranges of movement, achy pain at rest, and difficulty sleeping. Next, the freezing stage can last from 3-9 months, and individuals experience progressive loss of motion in all directions. The third stage, also known as the “frozen stage” is when there is continued pain and loss of motion. This can last from 9-15 months. The fourth and final stage known as the “thawing stage” is when pain begins to resolve but there is lasting stiffness in the joint which can persist from 15-24 months since the initial onset of the condition. Although this can be a lengthy process, physical therapy can help during the various stages of the condition.
How can PT help?
Your physical therapist can perform a thorough examination to help determine the diagnosis of adhesive capsulitis and the stage of the condition. Research has shown that the most effective intervention is corticosteroid injections in conjunction with shoulder mobility and stretching exercises to reduce pain. Physical therapy can also assist in providing different modalities including diathermy, ultrasound, or electrical stimulation to help reduce pain in the shoulder. During the thawing stage of the condition, therapists may perform joint mobilizations to progressively regain motion in the affected shoulder. There are various ways physical therapists may assist individuals in management of their pain and provide activity modification techniques to continue to participate in daily life.
Jill Hoffman, PT, DPT is a physical therapist specializing in treating orthopedic conditions.