Adhesive capsulitis

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  • Also known as "frozen shoulder syndrome"
  • Inflammation of glenohumeral joint → joint capsule fibrosis, shoulder restriction
  • Must rule-out posterior shoulder dislocation
  • Associated with:

Clinical Features

  • Stage 1 (first 2-3mo)
    • Acute synovial inflammation with limitation of shoulder movement due to pain
  • Stage 2 (months 3-9)
    • "Freezing stage"
      • Decreased shoulder motion due to capsular thickening/scarring; patient has chronic pain
  • Stage 3 (months 9-15)
    • "Frozen stage"
      • Less pain, but significantly decreased range of motion
  • Stage 4 (months >15)
    • Minimal pain, progressive improvement in shoulder range of motion


  • Hallmark is limited active and passive range of motion
  • Pain
    • Diffuse, aching, poorly localized, accompanied by stiffness, worse at night
    • Not typically reproducible by palpation

Differential Diagnosis

Shoulder and Upper Arm Diagnoses



Refered pain & non-orthopedic causes:


  • Avoid immobilization
  • Analgesia
  • Oral steroids
    • Provide significant short-term benefit in terms of relieving pain and improving ROM


  • Refer to primary care for physical therapy