Introduction

Adhesive capsulitis (frozen shoulder) is a common cause of shoulder pain. It is most common in middle-aged females. The aetiology of frozen shoulder is not fully understood.

Epidemiology

  • Incidence: 150.00 cases per 100,000 person-years
  • Peak incidence: 50-60 years
  • Sex ratio: more common in females 2:1
Condition Relative
incidence
Rotator cuff injury2.00
Adhesive capsulitis1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Aetiology

Associations
  • diabetes mellitus: up to 20% of diabetics may have an episode of frozen shoulder

Clinical features

Features typically develop over days
  • external rotation is affected more than internal rotation or abduction
  • both active and passive movement are affected
  • patients typically have a painful freezing phase, an adhesive phase and a recovery phase
  • bilateral in up to 20% of patients
  • the episode typically lasts between 6 months and 2 years

Management

Management
  • no single intervention has been shown to improve outcome in the long-term
  • treatment options include NSAIDs, physiotherapy, oral corticosteroids and intra-articular corticosteroids