Adhesive capsulitis is characterised by painful, gradual loss of active and passive shoulder motion often with no causal event.
The condition normally progresses through three phases. The first phase is characterized by pain and stiffness and usually lasts for three to four months. In the second phase the pain resolves and stiffness is the predominant feature. The final phase is the gradual resolution of the stiffness.
Initial management involves oral medication to treat the pain and gentle physiotherapy or hydrotherapy to maintain shoulder motion. Intra-articular injections of local anaesthetic and corticosteroids can be helpful in diagnosis and treatment of the acute, painful phase.
Residual stiffness that does not respond to physiotherapy may require surgery. The aim of surgery is to release the tight, scarred capsule and tendons of the shoulder joint. This is performed using an arthroscopic (key-hole) procedure.
It is imperative to follow the procedure with a diligent physiotherapy program in order to maintain the joint mobility gained during surgery.