Adhesive capsulitis – frozen shoulder
- This is a poorly-understood condition in which there is inflammation and shortening (contracture) of the capsule and ligaments of the shoulder.
- This causes pain, stiffness and disability.
- It typically occurs after the age of forty and is more common in diabetics.
- The disease has an ascending phase, a plateau phase and a descending phase. Without treatment it can take between six months to two years to recover.
- The condition can be mild with minimal pain and impairment; or severe with continuous pain, complete stiffness and extreme disability.
- Pain is felt in and around the shoulder. It becomes worse with physical activity, especially overhead actions. Reaching the back also becomes very difficult.
- In severe cases the pain is continuous and may be worse at night.
Treatment
- Mild cases resolve on their own; or with physiotherapy and exercises (along with painkillers).
- In severe cases these measures do not work. In such cases further treatment will be required:
- Hydrodilatation (Joint Distension) with saline. This can be effective in some cases. It may have to be repeated in some patients.
- Manipulation under anesthesia (usually combined with steroid injection). Here the shoulder is mobilized under anesthetic. Sometimes excessive force may be required which can result in tears of the rotator cuff or even fracture of the humerus. Hence it is less favoured now-a-days.
- Arthroscopic Release: This is done for severe cases where the pain is continuous and there is extreme stiffness and disability. Some of these patients would also have tried manipulation without success. In this procedure, the thickened capsule and ligaments are released carefully under vision using a radio-frequency ablator. This gives very good relief of pain and restores function to the shoulder.
Call +91 9900236845