Adhesive capsulitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Adhesive capsulitis affects 2% to 5% of the population. It is slightly more common in women than in men, and is most common in people between 40 and 70 years of age.
Recent history of traumatic shoulder injury, prior surgery to affected shoulder, diabetes mellitus, thyroid disease, and previous history of adhesive capsulitis are all risk factors for developing adhesive capsulitis.
Mainstay of treatment is physical therapy and observation. Evidence shows that nonsteroidal anti-inflammatory drugs and injected corticosteroids may also be beneficial.
Refractory cases may require a surgical capsular release. This can be performed reliably and satisfactorily with arthroscopic techniques.

Arthroscopic view of contracted rotator interval showing extensive scarring and synovitis

From the private collection of Matthew T. Provencher, MD, CDR MC USN and Lance E. LeClere, MD, LCDR MC USN; used with permission

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Spurling maneuver
O'Brien test
Yergason test
Apprehension test
Kim test
Examples of provocative examination maneuvers used to exclude labral, rotator cuff, and cervical spine pathology
Demonstration of sleeper stretch exercise
Arthroscopic view of contracted anterior capsule with extensive synovitis and thickening
Arthroscopic view of completed anterior release
Arthroscopic view of contracted rotator interval showing extensive scarring and synovitis
Arthroscopic view of rotator interval release
Arthroscopic view of posterior capsular release

Citations

Key Articles

Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis: a prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am. 2000 Oct;82(10):1398-407.[Abstract]
Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder: a long-term follow-up. J Bone Joint Surg Am. 1992 Jun;74(5):738-46.[Abstract]
Hannafin JA, Chiaia TA. Adhesive capsulitis: a treatment approach. Clin Orthop Relat Res. 2000 Mar;(372):95-109.[Abstract]
Tighe CB, Oakley WS Jr. The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J. 2008 Jun;101(6):591-5.[Abstract]
Page MJ, Green S, Kramer S, et al. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014 Aug 26;(8):CD011275.[Abstract][Full Text]

Referenced Articles

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39. Vermeulen HM, Rozing PM, Obermann WR, et al. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther. 2006 Mar;86(3):355-68.[Abstract][Full Text]
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42. Buchbinder R, Green S, Youd JM, et al. Oral steroids for adhesive capsulitis. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006189.[Abstract][Full Text]
43. Lorbach O, Anagnostakos K, Scherf C, et al. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg. 2010 Mar;19(2):172-9.[Abstract]
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51. Jacobs LG, Smith MG, Khan SA, et al. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg. May-Jun 2009;18(3):348-53.[Abstract]
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54. Ranalletta M, Rossi LA, Bongiovanni SL, et al. Corticosteroid injections accelerate pain relief and recovery of function compared with oral NSAIDs in patients with adhesive capsulitis: a randomized controlled trial. Am J Sports Med. 2016 Feb;44(2):474-81.[Abstract]
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65. Warner JJ, Allen AA, Marks PH, et al. Arthroscopic release of postoperative capsular contracture of the shoulder. J Bone Joint Surg Am. 1997 Aug;79(8):1151-8.[Abstract]
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77. El Naggar TEDM, Maaty AIE, Mohamed AE. Effectiveness of radial extracorporeal shock-wave therapy versus ultrasound-guided low-dose intra-articular steroid injection in improving shoulder pain, function, and range of motion in diabetic patients with shoulder adhesive capsulitis. J Shoulder Elbow Surg. 2020 Jul;29(7):1300-9.[Abstract]
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