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Frozen Shoulder

Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, and grows together with abnormal bands of tissue, called adhesions, greatly restricting motion and causing chronic pain.

It has an incidence of 2.4/1000 per year. Adhesive capsulitis is a painful and disabling condition that often causes great frustration for patients and caregivers due to slow recovery. Movement of the shoulder is severely restricted. Pain is usually constant, worse at night, and along with the restricted movement can make even small tasks impossible. Certain movements can cause sudden onset of tremendous pain and cramping that can last several minutes.

This condition for which an exact cause is unknown, can last from 5 months to 3 years or more, and is thought in some cases to be caused by injury or trauma to the area. It may also appear for no apparent reason. It is also believed that it may have an autoimmune component, with the body attacking healthy tissue in the shoulder. The condition may also cause chronic inflammation. Adhesions grow between the joints and tissue, greatly restricting motion and causing a number of painful complications. There is also a lack of fluid in the joint, further restricting movement.

In addition to difficulty with everyday tasks, people who suffer from adhesive capsulitis usually experience problems sleeping for extended periods due to pain that is worse at night and restricted movement/positions, resulting in chronic fatigue and other complications. The condition also can lead to depression, pain and problems in the neck and back, as well as damage to the tissue surrounding the area.

There are a number of risk factors for frozen shoulder, including diabetes, stroke, accidents, lung disease, connective tissue disorders, and heart disease. The condition very rarely appears in people under 40.

Treatment is painful and taxing, and consists of physical therapy, various medications, massage therapy, and in severe cases, surgery. A doctor may also perform manipulation under anesthesia, which breaks up the adhesions and scar tissue in the joint to help restore some range of motion.

In approximately 15% of patients, adhesive capsulitis may appear in both shoulders, at different times or together. People who suffer from adhesive capsulitis may have extreme difficulty working and going about normal life activities for several months or longer.