Adhesive shoulder capsulitis, commonly called frozen shoulder syndrome, is a very painful inflammatory disease, which progressively limits shoulder movement over time until it is completely rigid. It is especially common in women between 35 and 55 years of age.

The disease is not always diagnosed early: symptoms are sometimes associated with a general “inflammation” or more simply with neck pain. The delay in proper treatment thus lengthens the healing time.

We talk about it with Dr. Mario Borroni, specialist in shoulder and elbow orthopedics in Humanitas.


What are your symptoms?

The disease develops mainly in three phases:

In the first phase, which usually lasts three to four months, “freezing” occurs, i.e. the progressive loss of shoulder movement and an exacerbation of pain.

In the second phase, which generally lasts from four months to a year, the pain decreases slightly but the stiffness of the shoulder remains. In severe cases, numbness of the hand may also occur.

The third phase is that of “defrosting”, which usually lasts from one to three years; this is the period of total or partial recovery of movement and the gradual return to normal function.


What causes frozen shoulder?

This condition occurs when the connective tissue capsule (i.e. the structure that regulates shoulder movement together with ligaments) shrinks and ignites, thus preventing normal articulation.

Studies show that people with diabetes are more likely to develop this disease, but also those with autoimmune or thyroid diseases are also likely to develop it.

Finally, forced fixed immobilizations may also be affected for a certain period, following an accident or surgery on both the shoulder and the breast.


Treatment options

Timely treatment of the disease is essential to quickly reduce pain and accelerate the healing process with recovery of movement.

“The evolution of adhesive capsulitis tends to be benign and this condition may also resolve spontaneously. To treat the initial symptomatology, oral cortisone therapy is generally indicated and we invite the patient to try to move the arm in respect of the pain, trying not to make the joint even more rigid. In this initial phase it is also possible to recommend the occasional use of a brace to limit pain. This can also be achieved with therapy based on interferential currents.

As soon as possible, the physiotherapist should be called in for the functional recovery of the joint and thus of mobility. We must prevent the shoulder from becoming even more rigid.

Where therapies are not effective and pain limits the patient’s daily activities, arthroscopy can be used surgically. However, this happens in rather rare cases”, concluded Dr. Borroni.