Adhesive Capsulitis

Adhesive capsulitis, commonly known as frozen shoulder, is a shoulder ailment that results in pain and restricted motion in the shoulder.  

It is not entirely known why people become affected, but there are several predisposing factors, including diabetes and other hormonal/endocrine disorders.  Injuries, strokes, and treatment for breast cancer also can lead to the condition.  It is more common in women and people between 40-60 years of age.

The condition is referred to as “frozen” shoulder because of the development of motion loss and a feeling of the shoulder being “frozen” in position.

Symptoms of frozen shoulder are divided into three stages:

  • The “freezing” stage:
    In this stage, the shoulder becomes stiff and is painful to move. Inside the shoulder joint, the capsule is very inflammed and red. The shoulder is often extremely painful even at rest.  Night pain is common.  Motion gradual lessens over weeks to months.
Arthroscopic image of an inflammed shoulder capsule ( synovitis ) in a patient with adhesive capsulitis
  • The “frozen” stage:
    In this stage, pain is usually not constant and does lessen.  The  shoulder is often only painful if one attempts to move beyond the restricted range.  Motion remains limited and can affect daily tasks, including putting on bras and shirts as well as personal hygiene.  
  • The “thawing” (recovery) stage:
  • In this stage, pain lessens, and ability to move the shoulder slowly improves. For some, a full restoration of motion and function can occur, but this may take 1-2 years.

For patients that do not improve with conservative treatment, surgical intervention can be considered. The surgery consists of a shoulder arthroscopy with release of tight capsular tissue and debridement of scar and inflammed tissue. The success of this surgical procedure is well greater than 90% but aggressive physical therapy is necessary after surgery to restore and maintain good motion and function.

Arthroscopic image of a patient’s shoulder after a release and debridement

Watch a video of a shoulder arthroscopy with capsular release and debridement