Adhesive capsulitis, also know as “frozen shoulder” is a condition characterized specifically with shoulder pain and limited passive range of motion and active range of motion, of the glenohumeral joint. The limitation on motion is in all planes but most common in abduction and external rotation. The causes are not completely clear, but it can develop from a minor incident, rotator cuff strain, impingement syndrome, surgery after trauma and long periods of immobilization. Also the condition is related to other medical conditions such as osteoarthritis diabetes, thyroid disease, Parkinson’s, and cardiac disease. Most common in individuals age older than 40, more in women than men, and diabetes mellitus type I, seems to be the most common risk factor.
Symptoms for adhesive capsulitis include; pain and a decrease range of motion. The condition progress through stages, basically start with thickening and contracture of the shoulder joint capsule. This stages can be divided in three; the freezing stage or painful, the frozen stage or adhesive, and the thawing stage or recovery. The first stage can last from the time of onset about ten to thirty six weeks, and symptoms of severe pain with movement, muscle spasm, and an increasing pain at night and at rest. The second stage last from four to twelve months, with less pain, an increase stiffness and restriction on movement, the pain at night is less, but the key point in this stage is that discomfort is felt at extreme range of movement. The last stage last for twelve months and sometimes for years, and most of the patients show a decrease in pain, and gradual increase in range of motion.
One of the main goals for the physical therapist is to control pain and improve the range of motion for the patient. In most of the cases because of the pain at night physicians will recommend the use of antidepressant medication as a sleep aid. The...