Adhesive Capsulitis (Frozen Shoulder)

Brandon D. Hecht, DO Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Adhesive capsulitis (AC) is a painful, gradual loss of active and passive glenohumeral (GH) motion due to progressive fibrosis/contracture of the GH joint capsule.

  • The clinical course...

DIAGNOSIS

HISTORY

  • Insidious onset of progressive, diffuse shoulder pain and stiffness

  • Pain predominates early in the course of the disease:

    • ▪ Night pain often interrupts sleep.
    • ▪ Debilitating pain: achy a...

TREATMENT

  • Treatment is guided by the stage of AC at presentation. Initially, conservative therapy is recommended (for 4 to 6 months).

  • Therapy includes combination of physical therapy, oral medications,...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Reinforce the natural course of the disease. Many patients are more likely to request invasive procedures (injections, capsular distension, MUA, surgery) when sti...

REFERENCES

Jain  TK, Sharma  NK. The effectiveness of physiotherapeutic interventions in treatment of frozen shoulder/adhesive capsulitis: a systematic review. J Back Musculoskelet Rehabil.  201...

ADDITIONAL READING

  • Ewald A. Adhesive capsulitis: a review. Am Fam Physician.  2011;83(4):417–422.

  • Maund E, Craig D, Suekarran S, et al. Management of frozen shoulder: a systematic review and cos...

CODES

ICD10

  • M75.00 Adhesive capsulitis of unspecified shoulder

  • M75.01 Adhesive capsulitis of right shoulder

  • M75.02 Adhesive capsulitis of left shoulder

ICD9

  • 726.0 Adhesive capsulitis of shoulder

SNOMED

  • 39911...

CLINICAL PEARLS

  • Early-stage AC is difficult to distinguish from rotator cuff pathology. Restriction of external ROM suggests AC.

  • Diagnostic subacromial bursa injection may help differentiate early AC f...

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