An Overview on Frozen Shoulder and Adhesive Capsulitis
Frozen shoulder (FS) sometimes called adhesive capsulitis is a common shoulder condition that results in significant pain and loss of shoulder mobility. Sufferers often report shoulder stiffness in the early stages of this condition. Neglect of a stiff shoulder often leads to additional symptoms that include an inability to lift the arm to shoulder levels. The clinical teams of Chiropractic Specialty Center® are the experts you need for non-invasive recovery and repair of the damaged shoulder joint or tissues. The care you get from our teams of chiropractors and physical therapists is through manual and modality rendered procedures. The combination of advanced therapeutic devices and targeted manual treatments of a frozen shoulder syndrome (FSS) is the reason why our patients recover faster. So, if you are not keen on having injections or surgery for a frozen shoulder, visit one of our centers today.
Is Adhesive capsulitis and FSS the same?
A common misconception amongst patients and some clinicians is that adhesive capsulitis is one and the same as FSS (frozen shoulder syndrome). Although these terms are used interchangeably, there are differences. In others words, they may describe similar symptoms, but the actual cause may be entirely different. As such, we believe that adhesive capsulitis differs from the FSS, and here is why:
What Causes Adhesive Capsulitis?
As mentioned, adhesive capsulitis and FS (frozen shoulder) are terms used interchangeably. There are differences as to the actual cause. However, the jury is still out on the actual cause of adhesive capsulitis and frozen shoulder. Some report it as an associated disorder to an autoimmune disorder. Most believe it to be due to an inflammatory process within the joint capsule. Others relate it to muscles, tendons and inflamed bursae of the shoulder griddle. But, the reality is that they all have merits. However, the most common cause of most FS or adhesive capsulitis is irritation or damage of the attaching soft tissues (ligaments, muscles, and tendons) and bursae (inflamed bursa or bursitis).
The shoulder joints are held together with attaching ligaments. Mobility is through the shoulder muscles and tendons. The bursa acts as lubricant and spacers for the tendons and muscles that surround the shoulder griddle. Irritation, damage or injury at any of these tissues can lead to degenerative a change that produces inflammatory processes, decreased mobility, and pain. If we break the term and look at them separately, it may become easier to understand:
- “Capsulitis” is an inflammatory process of the capsule or the shoulder socket.
- “Adhesive” is term denoting sticking, cementing or gluing together
Therefore, adhesive capsulitis as it stands is an inflammatory process that impacts the shoulder joint. In other words, the tradition or primary form of adhesive capsulitis is damage to the shoulder joint and shoulder socket. Muscle injury and tendons tears as seen in the rotator cuff issues are secondary forms of adhesive capsulitis. Let’s repeat that again, primary adhesive capsulitis is related to disorders within the joint capsule. Secondary adhesive capsulitis arises from rotator cuff issues or bursitis.
What is the Role of Damaged Joint Ligaments in Adhesive Capsulitis?
Joints are encapsulated. The term encapsulated as it pertains to joint addresses the soft tissues that surround, enclose or envelops a joint securely. The articulations in your shoulder are held firmly in place by shoulder joint’s capsule. This capsule is a collection of tissues and ligaments that firmly holds the joint together. The innermost parts of the shoulder capsule are made of membrane called the synovium. The synovium houses the synovial membrane is filled with synovial fluids. Synovial fluids are the needed liquid for lubrication and sustenance of cartilage and tissues within the shoulder joint.
Four articulation are make up the ‘shoulder joint. Direct or indirect traumatic events will impact the encapsulating tissues. It can lead to degenerative changes in the encapsulating ligaments. These degenerative changes are the leading causes of primary adhesive capsulitis better known as the frozen shoulder.
What are the Common Symptoms of Adhesive Capsulitis?
Loss of mobility and pain with shoulder movements are classic symptoms in the frozen shoulder (adhesive capsulitis). As mentioned, frozen shoulder if often caused by either injury or degenerative changes that take place over time. Some believe the common cause could be spontaneous, but we disagree. Any symptoms or pain you experience has a purpose or reason. In the so-called spontaneous cases, premature degenerative changes are the leading factors.
The development of adhesive capsulitis may also be due to a secondary condition including neck issues, upper back issues, rheumatoid diseases, heart disease, adrenal issues, thyroid problems, and even recent shoulder surgery.
How many joints are there in the shoulder?
The shoulder is the most mobile joint in the body. No other articulation has the same or similar ranges of motion as the shoulder does. The shoulder’s increased mobility is due to its shallow joint surfaces, encapsulating ligaments and of course the muscles that provide mobility. Another reason for increased mobility is the number of joints that allows for this motion. The shoulder joint is not a singular joint, but a series of four joints working collaboratively to provide the mobility we need for daily life. We have submitted a brief list of these joints below for your review:
Are there Different Types of Adhesive Capsulitis?
There are two main categories of frozen shoulder or adhesive capsulitis:
- Primary Frozen Shoulder (True Adhesive Capsulitis)
- Secondary Adhesive Capsulitis or Frozen Shoulder (True Frozen Shoulder)
As mentioned numerous times before, frozen shoulder and adhesive capsulitis are terms used interchangeably with differences in etiology. What we mean by that is that while there are many similarities, they differ in the actual cause.
What is the Actual Cause of Primary Adhesive capsulitis?
Primary or TRUE Adhesive Capsulitis is a condition related to other diseases. In other words, another health condition was the reason why adhesive capsulitis emerged. The most common co-conditions that could result in adhesive capsulitis include autoimmune disease (such as rheumatoid arthritis), diabetes, heart disease, stroke, Parkinson’s, hypothyroidism, lung diseases, and even shoulder surgery or neck dissection. In fact, published research reports the prevalence of adhesive capsulitis at 20% in patients with diabetes. Patients with the primary adhesive capsulitis (secondary frozen shoulder) will complain of pain and loss of mobility.
What are the Causes of TRUE FSS or SECONDARY Adhesive Capsulitis?
The SECONDARY adhesive capsulitis or “true frozen shoulder syndrome” (FSS) is often due to damage or degenerative changes in the major shoulder muscles and tendons of the rotator cuffs. Conditions such as rotator cuff tears, bursitis, tendonitis, or bone spurs (Acromio-Clavicular spurs) are common causes of the secondary adhesive capsulitis or a “true frozen shoulder syndrome” or FSS.
The rotator cuffs are a group of four muscles that help mobility and keep the shoulder joint stable. The four significant mobilizers or stabilizers of the shoulder are:
- Supraspinatus muscle
- Infraspinatus muscle
- Teres minor muscle
- Subscapularis muscle
How is the Primary Adhesive Capsulitis Differentiated from a Secondary Adhesive Capsulitis or FSS?
Again, there are differences between primary and secondary forms of adhesive capsulitis. The secondary adhesive capsulitis or the “true frozen shoulder syndrome” (FSS) is related to damage, irritation or injury of the rotator cuffs, bursae or emerges for arthritic changes in the associated shoulder joints. Although similarities are significant, our expert non-surgical clinical teams use a variety of means to distinguish the differences. Identifying the actual cause of shoulder pain is the critical step in recovery. In other words, it is imperative to distinguish primary adhesive capsulitis from a secondary or the “true frozen shoulder syndrome” or FSS.
MRI or Magnetic Resonance Imaging is the Gold Standard in Shoulder Assessment
X-rays and diagnostic ultrasound have had some successes in the assessments of shoulder pain. But, none has proven as helpful as the MRI. Magnetic Resonance Imaging (MRI) can detect tears in muscles or tendons. It is also the best modality in assessing bone spurs, cartilage, joint capsule, ligaments and even pathology. In short, if you have shoulder pain that won’t go away, you should ask your doctor for MRI. The chiropractors and physiotherapists of Chiropractic Specialty Center® are the best non-surgical experts when it comes to diagnosing and treatments of shoulder pain. Our clinical teams have the knowledge needed to identify the actual cause of your shoulder pain.
In our center, a Doctor of Chiropractic will thoroughly assess your shoulder. We will also evaluate your neck, upper back, and chest (ribcage) to identify the cause before treatments. Often, there are multiple causes. Recovery is possible with our targeted care that addresses the actual cause. The care you get from us is through the best chiropractors and physiotherapists in Malaysia. Our method of care and treatments used for a frozen shoulder will get you back to active life faster. Call us now.
What is the BEST Treatment for Adhesive Capsulitis or FSS?
Spine, joints, and sports injuries are best treated through conservative methods. For conservative treatments to work, care must be targeted to tissues damaged or irritated. Adhesive capsulitis or FSS (frozen shoulder syndrome) treatments depend on the actual cause. Both primary and secondary causes of adhesive capsulitis are in need of conservative treatment. However, primary adhesive capsulitis patients will require care from other specialists in tandem with the treatments we provide. Our clinical physiotherapists and advanced chiropractors will inform you of this need should it arise.