Frozen Shoulder

A syndrome in which a stiff shoulder is restricted and painful in both active and passive movement. Also known as adhesive capsulitis, periarthritis, and pericapsulitis. The involved joints are the scapulothoracic and glenohumeral. There is no bony ankylosis. Causes include any type of pain in the shoulder upon movement, and immobilization from shoulder injury. Frozen shoulder is seen most often in patients with tendency to tension, anxiety, and passive apathy (termed the periarthritis personality), combined with a low pain tolerance. The pathology of frozen shoulder is believed to be as follows: pain in the shoulder (neurologic, vascular, musculoskeletal, or referred visceral): causes vasospasm which leads to congestion, and myospasm which leads to disuse and further vascular congestion. This  initiates  the  development of fibrous tissues that are responsible for functional disability. The untreated course ends in total immobilization of the shoulder joint. Prevention is the best treatment. Once the condition is established, cure becomes increasingly difficult. It is unusual for a complete recovery to occur in frozen shoulder patients. Conventional treatment consists of drug therapy (muscle relaxants, sedatives, tranquillizers, analgesics); manipulation of the shoulder; passive and active range of motion exercises; ice; physiotherapy; and psychological counseling to dispel any anxiety and dependency that may be primary or secondary to the frozen shoulder.