The shoulder joint is enclosed by soft tissue capsule which surrounds the shoulder and creates flexible “sack” around the joint and allows for free motion. Adhesive capsulitis, also known as “frozen shoulder”, occurs when the joint capsule becomes severely inflamed and thickened, leading to severe stiffness of the joints. The cause of adhesive capsulitis is not clearly understood, but the condition is more commonly seen in middle aged individuals, females and patients with hormonal disorders and diabetes.

Adhesive capsulitis manifests as pain and/or significant stiffness and limited range of motion in the shoulder joint. Early on, the pain is pronounced by motion reasonably preserved. With time, pain subsides but the stiffness increases dramatically.

Adhesive capsulitis typically improves without significant interventions, but the process can take a long time, usually over a year. During that time however, shoulder function can be very limited, and the patient’s quality of life affected significantly.

Diagnosis of shoulder frozen shoulder is made by the patient’s history and the findings on physical examination. X-rays are frequently obtained to rule out other possible sources of pain and stiffness. If there is a diagnostic dilemma, an MRI scan may be obtained, and can show diminished joint space and thickening of the shoulder joint capsule.
Treatment is typically non-operative initially. Generally, a cortisone injection inside the joint can be very helpful in alleviating pain. It is important to initiate physical therapy stretching exercises daily to help loosen the stiffened capsule. Depending on the duration of symptoms and comorbidities, among other factors, this approach can be successful. For longstanding symptoms, severe stiffness or lack of improvement however, surgery may be necessary.

At Oceana Sports Medicine and Orthopaedic Center, Dr Aboka performs minimally invasive, all-arthroscopic treatment for frozen shoulder through keyhole incisions. This cutting-edge technique allows for release of the stiffened capsule structures and gentle mobilization of the shoulder under anesthesia, to allow the joint to loosen. Also, thorough inspection of the shoulder joint, can facilitate identification and treatment of other painful conditions that may be present, ensuring return to good shoulder function. This procedure is outpatient/same-day surgery, and leads to less pain and scarring and quicker recovery, and much improved outcomes with physical therapy.