also known as adhesive capsulitis basically is an inflammatory painful stiff condition of shoulder joint that develops gradually causing pain which can get worse at night and limits shoulder range of motion.
EPIDEMIOLOGY
It involves individual aging between 40-70 years with mean prevalence of 30% patients with diabetes with higher majority of prevalence among type-1 diabetes patients and lifetime prevalence of frozen shoulder is estimated around 2-5% among general population
CLINICAL FEATURES AND PATHOPHYSIOLOGY
Frozen shoulder can be Primary (Idiopathic) or Secondary (due to any underlying disease) It consists of 3 stages viz. 1. Painful stage 2. Freezing stage 3. Thawing stage Clinically presented with
Pain, Loss of Range of motion, Stiffness
Pain is not localised may radiate to biceps area and deep seated pain in nature it may be localised around anterior or posterior capsule.
PHYSICAL EXAMINATION AND DIAGNOSIS
Adhesive Capsulitis hallmarks loss of range of motion so examine Range of shoulder motion in all planes and movements viz flexion, extension, abduction, adduction, internal and external rotation
For internal rotation its recommended to use Apley’s scratch test
Palpation may reveal diffuse vague tenderness over anterior and posterior shoulder
If loss of motion is observed therapist may apply scapular stabilization and assist movement for accurate testing
Radiography is not that useful however can be performed to rule out other pathology MRI may reveal capsular thickening Basic diagnostic tool is physical examination ROM testing,Palpation etc
Indexes included for measuring frozen shoulder pain and disability
Shoulder Pain and Disability Index
Disability of Shoulder and Hand
Simple Shoulder test
Penn Shoulder Scale
VAS etc
DIFFERENTIAL DIAGNOSIS
Osteoarthritis Shoulder
Rotator Cuff Pathology
PTS syndrome
Biceps tendinopathy
Bursitis
TREATMENT
Medical management include use of corticosteroids, NSAIDS, Intracapsular Corticosteroid injection etc Surgical Management include Arthroscopic surgery, joint manipulation under anaesthesia to break adhesions but has moderate evidence to alleviate pain Physiotherapy is the cornerstone for frozen shoulder techniques include shoulder manipulation and mobilisation, ROM exercise, stretching techniques, Strengthening exercise, Modalities such as ultrasound, iontophoresis, cryotherapy, TENS are used to relieve pain. Physiotherapy along with Corticosteroid injection do miracles and help in long term relief
For Stretching and Strengthening exercises for frozen shoulder visit
https://www.health.harvard.edu/shoulders/stretching-exercises-frozen-shoulder
For more info visit