Adhesive capsulitis of the shoulder

Abstract

Introduction Adhesive capsulitis of the shoulder, or frozen shoulder, is a common upper limb orthopaedic condition affecting up to 10% of the population. It is characterised by pain in the shoulder of insidious onset, limiting range of movement globally, little local tenderness and crucially the lack of radiographic abnormalities. It is associated with certain medical conditions such as diabetes mellitus and Dupuytren contracture. Pathologically, the joint capsule becomes inflamed and subsequently contracts. Underlying inflammatory and fibroproliferative processes are likely to drive the disease process but these are still poorly understood. Clinically, the phases of 'freezing', 'frozen' and 'thawing' can be observed. Non-operative management involves corticosteroid injections, oral corticosteroid administration and physiotherapy. Operative management involves manipulation under anaesthesia, distension arthrography, arthroscopic release and open release. The aim of this critical review was to discuss adhesive capsulitis of the shoulder. Conclusion Higher level studies are required to compare common management options.