A frozen shoulder, also known as adhesive capsulitis, is a condition that occurs when the shoulder loses range of motion and becomes painful. A true frozen shoulder occurs when there is no other etiology for the loss of range of motion such as an underlying rotator cuff tear, impingement syndrome, or labral pathology.
Most frozen shoulders occur in Caucasian women between the age of 40 to 65. More resistance frozen shoulders occur in people with diabetes or hypothyroidism.
Frozen shoulders occur in three phases: 1. freezing, 2. frozen, and 3. thawing. The freezing phase occurs with a progressive loss of range of motion. Trying to place the shoulder in a position that stretches the shoulder past that range is very painful. Stiff shoulders are typically painful.
The frozen phase is marked by a plateau of the loss of range of motion.
The thawing phase of frozen shoulder occurs when the range of motion starts to improve and the pain is reduced. The condition may resolve on its on and be self limiting. There are some studies that show patients may continue to have symptoms up to 7 years after the condition starts and never resolve on their own.
Frozen Shoulder treatment options range from a home exercise program, physical therapy, a closed manipulation to arthroscopic release of the adhesion. An excellent article using level one evidence regarding which is the best conservative treatment option for a frozen shoulder was published in the April 2014 Journal of Shoulder and Elbow Surgery.
Authors Sarah Russell et al. found that a stretching program guided by a physical therapist with a group of patients produced the best results compared to a home exercise program or an individual program under the guidance of a physical therapist.