It is more common in people 40–60 years of age and in women. Signs and symptoms
Symptoms include shoulder pain and limited range of motion although these symptoms are common in many shoulder conditions. An important symptom of adhesive capsulitis is the severity of stiffness that often makes it nearly impossible to carry out simple arm movements. Pain due to frozen shoulder is usually dull or aching and may be worse at night and with any motion.The symptoms of primary frozen shoulder have been described as having three or four stages. Sometimes a prodromal stage is described that can be present up to three months prior to the shoulder freezing. During this stage people describe sharp pain at end ranges of motion, achy pain at rest, and sleep disturbances. Stage one: The "freezing" or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion. Stage two: The "frozen" or adhesive stage is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts from four to twelve months. Stage three: The "thawing" or recovery, when shoulder motion slowly returns toward normal. This generally lasts from 5 to 26 months.Physical exam findings include restricted range of motion in all planes of movement in both active and passive range of motion.
The goal of OT would be for the client to resume meaningful functional daily activities.The role for physical therapy in adhesive capsulitis is not settled. Physical therapy is used as an initial treatment in adhesive capsulitis with the use of range of motion (ROM) exercises and manual therapy techniques to restore range and function. A low-dose corticosteroid injection and home exercise programs in those with symptoms for less than 6 months may be useful. There may be some benefit with manual therapy and stretching as part of a rehabilitation program, but, due to the time required, such use should be carefully considered. Physical therapists may utilize joint mobilization directly at the glenohumeral joint to decrease pain, increase function, and increase range of motion as another form of treatment. There are some studies that have shown that intensive passive stretching can promote healing. Additional interventions include modalities such as ultrasound, shortwave diathermy, laser therapy and electrical stimulation. Another osteopathic technique used to treat the shoulder is called the Spencer technique. Mobilization techniques and other therapeutic modalities are most commonly used by physical therapists; however, there is not strong evidence that these methods can change the course of the disease.If these measures are unsuccessful, more aggressive interventions such as surgery can be trialed. Manipulation of the shoulder under general anesthesia to break up the adhesions is sometimes used. Hydrodilatation or distension arthrography is controversial. However, some studies show that arthrographic distension may play a positive role in reducing pain and improve range of movement and function.