Adhesive capsulitis or frozen shoulder is a condition where your shoulder gets painful and there will be gradual stiffening of the capsule resulting in limitation of your ability to move your arm up and reach behind your body. You may find it painful to lie on the affected shoulder resulting in sleep disturbance. The capsule is a joint lining which normally elastic in nature allowing large range of movement in the shoulder joint.
It can start for no obvious reason, but can occur following any injury or surgery of the shoulder joint. It is commonly seen in middle age (40-60 yrs.) and you are more prone if you are diabetic.
This condition often resolves completely but can last for 6 months to 3 years or more.
There are 3 stages to this condition
Freezing stage-The main problem in this stage is pain and there will be gradual restriction of movement and function of the arm. The capsule doesn’t get stretched and it will become tight, inflamed and thick.
Frozen stage – The pain reduces and limitation of movement or stiffness will be the main problem. There will be limitation in moving your arm in more than one direction.
Thawing stage– The stiffness slowly resolves and the movement and function gradually return.
There will be pain and tightness on the top of your arm, unable to reach up high or reach behind your back (eg fastening bra), pain and restriction moving your arm out to the side reaching above your head. This may cause difficulty in completing everyday tasks like driving and dressing. Pain in the shoulder which wakes you up at night and stops you from lying on the affected side.
Initial treatment is focussed on managing the pain with help of heat electrotherapy or acupuncture. Gentle exercises of your shoulder as the pain allows to maintain the range of movement and muscle power. Your Physiotherapist will be able to advice you on pacing your activities initially that involves spreading of your daily activities or exercises in to smaller and more manageable tasks. Consider taking regular breaks in your work or house hold tasks.
In the frozen stage Physiotherapy treatment is mainly focussed on improving the range of movement, normal movement pattern, posture and strength. Manual therapy, stretching and strengthening exercises along with electrotherapy are used in this phase to improve function in your arm.
Exercises are progressed depending on your tolerance and focussed on functional gains.