Adhesive capsulitis / frozen shoulder is characterised by stiffness and pain in the shoulder (occurs in the glenohumeral joint). Symptoms gradually worsen throughout the life of the condition and then usually resolve over an average time of 1.5 - 3 years.
- Over the counter or prescription NSAIDs (anti-inflammatory) medication. Consult GP to ensure this is appropriate based on individual health conditions and with current medication.
- Home exercises as detailed below.
Professional Medical Treatment
- Graded mobilisation by a physiotherapist as well as a home exercise program to stretch and strengthen the shoulder is the most common treatment for adhesive capsulitis. Strengthening exercises usually consist of a combination of rotator cuff and scapular stability exercises with progressive loading.
- Acupuncture or dry needling can both be used as an adjunct
- Muscular release around the shoulder
- Patient education about the condition by physiotherapist.
- Steroid injections of a corticosteroid may help decrease pain and improve range of motion, however evidence is poor
- Joint distention is an injection of sterile water into the joint which facilitates joint mobility and allows an aid to stretch the capsule. There is not strong evidence to support this
- Arthroscopic capsular release can be performed, however this is extremely rare
Physical Therapy Exercises
- Rehabilitation should follow a structured program of progressive strengthening exercises targeted at rotator cuff and other scapular muscles. Stretching of the shoulder capsule is also extremely important. Commitment to these exercises should be highly emphasised for optimal outcomes.
- Prevention focusses on addressing original causes of frozen shoulder. As immobility or reduced mobility is one of the main risk factors, range exercises during times of impaired shoulder function are extremely important. This is often extremely important post-operatively or following a stroke. Consult your physiotherapist about appropriate guidance regarding this.