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Am Fam Physician. 2003 Mar 15;67(6):1323-1324.
What is adhesive capsulitis?
If you cannot move your shoulder around like you used to, you might have adhesive capsulitis (say: add-he-sive cap-sool-eye-tis). When it hurts to move your shoulder or you do not have as much movement in your shoulder as before, your shoulder may be “frozen.” Because of this, doctors sometimes refer to this problem as “frozen shoulder.”
What are the signs of adhesive capsulitis?
You should be able to move your shoulder in all directions without pain. To test yourself, do these things:
Reach up toward the sky with both arms.
Reach your arms out straight in front of you.
Reach your arms out at the sides of your body.
Pretend that you are trying to unzip the back of your dress or pull your wallet from the back pocket of your pants.
If you have pain or stiffness in your shoulder when you try to do these things, you may have adhesive capsulitis. Your doctor may be able to tell if you have adhesive capsulitis just by talking to you and watching you move. Your doctor may press on parts of your shoulder to see what might be causing the pain. Sometimes, your doctor may want to take an x-ray of your shoulder to look for problems.
Does my shoulder actually freeze?
No, it just will not move. If you do not use your shoulder enough (because it hurts to move) or if you use it the wrong way, your shoulder will develop scar tissue that stops it from moving much. Your shoulder may go through several stages as the scar tissue forms.
1. The painful stage
At first, your shoulder may ache and feel stiff. Then it may get very painful. This stage may last about three to eight months.
2. The adhesive stage
During the second stage, you may not have as much pain, but your shoulder keeps getting stiffer. This stage usually lasts about four to six months.
3. The recovery stage
The final stage, which usually lasts about one to three months, is not very painful. It becomes hard to move your shoulder even a little bit. Then after a while, the stiffness slowly goes away. You can move your shoulder again. Although you may not get the full movement of your shoulder back, you should be able to do many more activities. As your shoulder movement increases, you may still have pain at times.
How is adhesive capsulitis treated?
Your doctor will tell you about exercises you should do to help break up the scar tissue in your shoulder. You may need a physical therapist to help with these exercises.
Sometimes the exercises hurt, so your doctor may give you medicine for the pain or to relax your muscles. Putting a heating pad or an ice pack on your shoulder for a few minutes first also may help you do the exercises with less pain. Always remember to warm up for 5 to 10 minutes before starting your exercises. Warm up by doing gentle exercises and making small movements with your shoulder before doing the exercises listed below. Don't forget to warm up and stretch other parts of your body (neck, back, hands, and elbows), too.
Here are three good exercises you can try:
1. Climbing the wall
Put your hand flat on a wall in front of you. Use your fingers to “climb” up the wall (like a spider). As you move your fingers up little by little, stop and hold your hand in place for 30 seconds every few inches. Move your fingers up the wall as high as you can reach. Keep trying to go higher.
2. Codman exercise
Sit sideways in a straight chair. Rest your armpit on the back of the chair. Now swing your arm slowly in circles. Make little circles at first and then make bigger circles. Make the circles in both directions.
Put things you use every day (shoes, coffee cup, toothbrush) on a high shelf. This way you have to reach up for things more often. The reaching is a good stretch for your shoulder.
Do the exercises once or twice a day even after your shoulder gets better. Your shoulder will get better only if you do the exercises. Do not forget to exercise your healthy shoulder, too, so that you can maintain the movement that you have in that shoulder.
Many people who have adhesive capsulitis get back full use of their shoulder. Others always have a little stiffness and pain in that shoulder. This stiffness usually is not very bad. You should be able to do all the activities you were doing before this happened.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2003 by the American Academy of Family Physicians.
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