Adhesive capsulitis (frozen shoulder):
- Common condition affecting 3 – 5% of the general population and 20% of the diabetic population.
- Often described as self-limiting; the majority of which resolve in 1-3 years although some patients will experience longer term movement deficit which lasts up to 10 years.
- A typical patient would be female in her 5th to 7th decade of life
- Rarely occurs simultaneously bilaterally although it can occur sequentially bilaterally.
- Normally classified as either primary: insidious onset of pain and progressive loss of movement at the shoulder or secondary; generally due to some form of trauma or subsequent immobilisation.
There are three distinct clinical phases:
- Freezing/painful stage; pain, worse at night decrease active and passive movement. Generally lasts for 3 – 9 months and is characterized by an acute synovitis of the glenohumeral joint
- The frozen/transitional stage. There is little change to the level of pain during this stage but range of movement loss can progress further. Lasts 4 – 12 months. A capsular pattern is therefore evident with most loss of external rotation followed by flexion/abduction and then internal rotation
- Thawing stage; starts when range of movement at the joint begins to improve. Generally lasts 12 – 42 months