Adhesive capsulitis is an inflammatory condition affecting the shoulder leading to joint contracture. It typically affects 3-5% of the population, 4x the number of women, and more commonly affects the non-dominant arm. There are two types, Primary and Secondary. Primary is often associated with Diabetes or Thyroid disorders. Secondary may be following trauma, stroke, or upper extremity surgery.
The symptoms begin insidiously and are initially non-specific. The diagnosis is initially unclear until passive range of motion loss occurs. Frozen shoulder or adhesive capsulitis typically occurs in 3 stages. These include a painful stage, freezing stage, and thawing stage. Range of motion is lost in all directions particularly with internal rotation, external rotation, and extension. It can sometimes be associated with underlying thyroid disease or diabetes. The capsule of the glenohumeral joint/synovium collapses or adheres to the joint restricting its range of motion. The symptoms can last for 5-24 months.
A common treatment utilized which can accelerate improvement combines glenohumeral hydrodilatation/distension with corticosteroid/ropivacaine in combination with a suprascapular nerve block. The Suprascapular nerve supplies 90% of the sensory fibers to the joint capsule and when anesthetized can reduce pain. The combined hydrodilatation with suprascapular nerve block can be helpful with the facilitation of physical therapy and earlier return to full range of motion.