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Adhesive capsulitis | Shoulder Arthroscopy | The Orthopaedic Clinic | Bangalore

Shoulder Arthroscopy

Adhesive Capsulitis/Frozen Shoulder

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Frozen Shoulder | Adhesice Capsulitis | The Orthopaedic Clinic | Bangalore

Peri-Capsular Release

Adhesive Capsulitis/Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. Frozen shoulder most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. Also, people with diabetes are at an increased risk of developing a frozen shoulder. In frozen shoulder, the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.

The hallmark signs of this condition are severe pain and being unable to move your shoulder -- either on your own or with someone else's help. It develops in three stages:

Stage 1: Freezing

In the "freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.

Stage 2: Frozen

Painful symptoms may improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.

Stage 3: Thawing

  • Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes 6 months to 2 years.

Frozen Shoulder Cause | Adhesive Capsulitis | The Orthopaedic Clinic | Bangalore


The causes of frozen shoulder are not fully understood. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.

Diabetes: Frozen shoulder occurs much more often in people with diabetes. The reason for this is not known. Also, diabetic patients with frozen shoulder tend to have a greater degree of stiffness that continues for a long time before "thawing."

Other diseases: Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.

  • Immobilization: Frozen shoulder can develop after a shoulder has been immobilized for some time due to surgery, a fracture, or other injuries. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.


Most patients with frozen shoulder get relief from a non-surgical treatment like NSAIDs and physical therapy with steroid injection. If the frozen shoulder does not respond to conservative treatment surgical option with the pericapsular release is the treatment of choice.

  • Manipulation under anaesthesia (MUA) without arthroscopic capsular release is effective but may result in iatrogenic injury, including fracture. Arthroscopic capsular release involves the selective release of the capsule, often with electrocautery, to minimize the risk of iatrogenic injury compared with MUA. Secondarily, this may decrease postoperative pain and facilitate early participation in physical therapy. In this procedure, arthroscopically, the surgeon cuts through the scar tissue that has formed in your shoulder joint capsule to allow free movement of your shoulder. Many patients find that surgical capsular release can offer permanent relief from the frozen shoulder in conjunction with a physical therapy program.

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