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Adhesive Capsulitis (Frozen Shoulder)

What is the Shoulder Capsule?


The capsule is a sleeve of connective tissue that surrounds the shoulder joint, keeping it stable while allowing movement.


What is This Condition?


Adhesive capsulitis, or “frozen shoulder,” occurs when the capsule becomes thickened and stiff, limiting motion and causing pain. It typically develops in stages — painful, frozen, and then thawing.


What Causes It?


  • Often develops without a clear injury (idiopathic)

  • More common in people with diabetes, thyroid disease, or after long periods of shoulder immobilization

  • Sometimes follows an injury or surgery


How is It Diagnosed?


  • Exam: loss of both active and passive motion is the hallmark sign

  • Imaging: X-rays are usually normal, but MRI may rule out other causes


How is It Treated?


Non-surgical:


  • Physical therapy to stretch and restore motion (mainstay of treatment)

  • NSAIDs for pain relief

  • Cortisone injections into the joint

  • Hydrodilatation (joint injection to stretch the capsule)


Surgical:


  • Manipulation under anesthesia or arthroscopic capsular release for patients who don’t improve with therapy


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