FROZEN SH O U LD E R

ADHESIVE C A PS U L IT I S
IÑA
PREPARED BY: AKIU DEQU
BACKGROUND OF FROZEN SHOULDER
• IT IS PATHOLOGICAL PROCESS WHICH BODY FORMS
EXCESSIVE SCARS TISSUE ACROSS THE
GLENOHUMERAL JOINT THAT CAUSES PAIN, STIFFNESS
AND DYSFUNCTION.

• IT IS A PAINFUL PROGRESSIVE LOST OF SHOULDER

MOTION.

• IT AFFECTS ACTIVE AND PASSIVE MOVEMENT OF THE

SHOULDER JOINT.

• GRADUAL START OF STIFFNESS, PAIN, AND LIMITED

RANGE OF MOVEMENT IN THE SHOULDER.

• COMMON IN THE WOMAN AGE 40 TO 70 YEARS OLD

• WOMEN SUFFER MORE FROM FROZEN SHOULDER

THAN MEN.
BACKGROUND OF FROZEN SHOULDER
• THE FIRST CASE REPORT SIMILAR TO ADHESIVE
CAPSULITIS WAS 1872 BY A FRENCH SURGEON SIMON
EMMANUEL DUPLAY AND CALLED IT “PERI-ARTHRITE
SCAPULO HUMERALE” , UNTIL IN 1934 WHEN EARNEST
CODMAN CALLED IT AS FROZEN SHOULDER.

• IN 1945, JULIUS NEVIASER REDEFINED THIS

CONDITION AS ADHESIVE CAPSULITIS WHERE THE
INFLAMMATORY AND FIBROTIC CHANGES IS
OBSERVED IN THE CAPSULES OR ADJACENT BURSA.
CAUSES/ETIOLOGY
• THE INFLAMMATION, SCARRING, THICKENING AND
SHRINKAGE OF THE CAPSULE THAT ARE
SURROUNDING THE NORMAL SHOULDER JOINT

• ANY SHOULDER INJURIES CAN CAUSE FROZEN

SHOULDER, INCLUDING TENDINITIS, BURSITIS AND
ROTATORS CUFF INJURY.
SIGN AND SYMPTOMS
• SHOULDER PAIN, STIFFNESS AND LOSS OF
RANGE OF SHOULDER MOTION.

• PAIN IN THE SHOULDER MUSCLE THAT WRAPS

AROUND THE TOP OF MUSCLE.

• PAIN DURING AT NIGHT.

• FROZEN SHOULDER TYPICALLY DEVELOPS

SLOWLY, AND IN THREE STAGES, EACH STAGE
CAN LAST A NUMBER OF MONTHS.
THREE PHASE OF FROZEN SHOULDER

• FREEZING STAGE, ANY MOVEMENT OF YOUR SHOULDER CAUSES PAIN, AND YOUR SHOULDER'S RANGE OF MOTION
STARTS TO BECOME LIMITED.

• FROZEN STAGE, PAIN MAY BEGIN TO DIMINISH DURING THIS STAGE, HOWEVER, YOUR SHOULDER BECOMES STIFFER,
AND USING IT BECOMES MORE DIFFICULT.

• THAWING STAGE, THE RANGE OF MOTION IN YOUR SHOULDER BEGINS TO IMPROVE.

RISK FACTORS
AGES AND SEX
• PEOPLE 40 AND OLDER, PARTICULARLY WOMEN, ARE
MORE LIKELY TO HAVE FROZEN SHOULDER.
IMMOBILITY OR REDUCED MOBILITY
• PEOPLE WHO'VE HAD PROLONGED IMMOBILITY OR
REDUCED MOBILITY OF THE SHOULDER ARE AT
HIGHER RISK OF DEVELOPING FROZEN SHOULDER
SYSTEMIC DISEASE
• PEOPLE WHO HAVE CERTAIN DISEASES APPEAR MORE
LIKELY TO DEVELOP FROZEN SHOULDER, DISEASES THAT
MIGHT INCREASE RISK INCLUDE: DIABETESS,
OVERACTIVE THYROID
(HYPERTHYROIDISM),UNDERACTIVE THYROID
(HYPOTHYROIDISM),CARDIOVASCULAR DISEASE,
TUBERCULOSIS, PARKINSON'S DISEASE
 PATHOPHYSIOLOGY
3
The initial inflammation of the
1 capsule leads to pain, and the
Inflammation occurs within the capsular fibrosis and adhesions
joint capsule and synovial fluid. lead to a decreased range of
motion.

2
The inflammation is followed
by reactive fibrosis and
adhesions of the synovial lining
of the joint.
DIAGNOSTIC TEST
• PHYSICAL EXAM IS USUALLY THE COMMON
DIAGNOSTIC TEST GIVEN FOR THE PATIENT WITH
FROZEN SHOULDER.

• BUT SOMETIMES DOCTOR ASK FOR IMAGING TEST

LIKE X-RAY, MRI AND ETC TO SEE WHAT ARE OTHER
PROBLEMS THAT MAY CAUSE PAIN AND MOVEMENT
LIMIT.
PROGNOSIS/PROSPECT OF RECOVERY
• AVOID REINJURING THE SHOULDER TISSUES DURING
THE REHABILITATION PERIOD.

• PATIENTS WITH RESISTANT FROZEN SHOULDERS CAN

BE CONSIDERED FOR RELEASE OF THE SCAR TISSUE
BY ARTHROSCOPIC SURGERY OR MANIPULATION OF
THE SCARRED SHOULDER UNDER ANESTHESIA. 

• WITHOUT AGGRESSIVE TREATMENT, A FROZEN

SHOULDER CAN BE PERMANENT.

• THE DURATION OF AC IS FROM 1 TO 3.5 YEARS WITH A

MEAN OF 30 MONTHS. IN ABOUT 15% OF PATIENTS, THE
CONTRA-LATERAL SHOULDER BECOMES AFFECTED
WITHIN 5 YEARS.
TREATMENT
• MEDICATION

• THERAPY

• SURGICAL AND OTHER PROCEDURES LIKE STEROID

INJECTION, JOINT DISTENSION, SHOULDER
MANIPULATION OR SOMETIMES SURGERY
REFERENCES
• HTTPS://WWW.GOOGLE.COM/AMP/S/MEDSPHERE.WORDPRESS.COM/2019/04/12/ADHESIVE-SHOULDER-CAPSULITIS/AMP

• HTTPS://WWW.WEBMD.COM/A-TO-Z-GUIDES/WHAT-IS-A-FROZEN-SHOULDER

• HTTPS://WWW.MAYOCLINIC.ORG/DISEASES-CONDITIONS/FROZEN-SHOULDER/SYMPTOMS-CAUSES/SYC-20372684

• HTTPS://WWW.NCBI.NLM.NIH.GOV/BOOKS/NBK532955

• HTTPS://PUBMED.NCBI.NLM.NIH.GOV/27641499/

• HTTPS://WWW.MEDICINENET.COM/FROZEN_SHOULDER/ARTICLE.HTM