In this video, Dr. J. Michael Bennett explains what causes adhesive capsulitis and frozen shoulder, and he also explains why early diagnosis and treatment is important. Dr. Bennett is a Shoulder Specialist, a Board Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Specialist. We have offices in Sugar Land near First Colony Mall and in Houston, near the Galleria. Call us at 281-633-8600 in Sugar Land and 713-234-3152 in Houston.
Number three, number three is something called adhesive capsulitis, which can become a frozen shoulder. This is a very common pathology. We see this primarily in patients that are number one female, number two have a history of thyroid problems, either hyper or hypothyroid or number three diabetics. There’s also the fourth category where it just generally can happen in idiopathically in anyone.
But that being said, adhesive capsulitis occurs when you start off having maybe injured your shoulder just doing some light activity, and you may have a little bit of soreness. You go to bed that night, you wake up the next morning, it’s a little bit more sore, becomes a little bit more painful. Gradually that pain gets worse over a period of time, and it gets to a point where it hurts to move your shoulder any direction whatsoever. You cannot move it forward, out to the side, behind your back, all those motions are inhibited and it gets harder and harder and harder as the pain gets worse and worse and worse.
So what happens is that the pain level, if you look at it from a chart standpoint will start out very, very minimal and get worse, worse, worse, increase, increase, increase and get to the point where it just plateaus. This is pain on this axis, okay. And as pain goes up it kind of levels out. The problem is, is that as the pain goes up, the range of motion gets worse, and patients lose more and more range of motion with their arm.
Once you reach this point, where the pain has plateaued and it’s not as bad, the range of motion in the shoulder has become very limited. And unfortunately for most of those people if they haven’t been diagnosed early enough, they basically have a frozen shoulder with very limited mobility.
At this point, patients have some limited options including extensive physical therapy or even a surgical capsular release and manipulation under anesthesia, where we can actually get different motion back. So the issue is trying to make the diagnosis early and preventing them from getting them to that frozen shoulder phase.
Frozen shoulder is almost like a perfect storm in the shoulder. What happens is you develop a little bit of bursitis in this space here, which is the subacromial space. You start protecting the shoulder, start not moving it as much and the soft tissues in the shoulder, which is the synovium and the capsule, the capsule surrounds this whole ball and socket, it’s underneath the tendon, starts to tighten up all the way around here.
If you look at on the top view down looking at the ball and socket here, this inflammation gets worse and then everything starts to kinda shrink and contract and that’s what creates the frozen shoulder. So it’s key to make that diagnosis early, so you can get the mobility and keep your mobility.
There are some treatment options using a cortisone shots or even oral steroids, but that’s usually going to be managed by your physician, in addition to doing aggressive physical therapy and home therapy. So the key with this pathology is making sure you get the diagnosis early, so you can implement a treatment program and prevent yourself from going down towards a frozen shoulder.
Ignoring adhesive capsulitis can lead to frozen shoulder and a more lengthy and treatment-intensive return to full activity. So don’t ignore your shoulder pain! If you’d like Dr. Bennett to evaluate your shoulder, please call our Sugar Land office at 281-633-8600 or our Houston office at 713-234-3152. Dr. Bennett has also created a video describing a typical shoulder examination so you’ll have an idea of what a shoulder exam is like.