What is the differences between a Frozen Shoulder and Adhesive Capsulitis?

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Frozen shoulder is often alternatively known as adhesive capsulitis, and for good reason – these two conditions both present themselves as pain in the shoulders, and is often accompanied by stiffness.

But while that is true, there are differences.

For example, adhesive capsulitis affects the capsule, which refers to the fibrous ligaments found surrounding the shoulder. However, frozen shoulder does not usually affect the capsule.

In most cases, the terms are still used interchangeably as both describe a very similar painful condition affecting the shoulders, regardless of the cause. However, a better way to put it is to consider frozen shoulder as a secondary type of adhesive capsulitis, whereas, an adhesive capsulitis affects the joint capsule, is the true form.

What may lead to further confusion is the fact that frozen shoulder might affect the joint capsule in certain cases. However, in the case of a frozen shoulder, it is the tightening of the surrounding muscle tissue due to damage such as muscular tears, or muscular inflammation, that results in subsequent tightening of the underlying capsule. While for a case of adhesive capsulitis, it is often a spontaneous inflammatory process in the connective tissue around the shoulder that results in the general tightening of the whole shoulder capsule.

How Is an Accurate Diagnosis Made?

Good question. Because of the similarities between the two conditions, it can be quite challenging to come up with an accurate diagnosis. Fortunately, orthopedic surgeons are well-equipped to do just that. One way of doing so is to conduct an arthroscopic exam, where tissue samples are taken from the inside of the joint as well as the surrounding areas, which are then examined closely under a microscope for further inspection.

Arthroscopic exams aren’t always necessary as well. There are certain differences that an experienced orthopedist can pick up on to correctly differentiate one from the other. Although both cases tend to result in a loss of shoulder movement in all directions, the subjective assessment is usually a good clue to tell them apart. The onset for frozen shoulder is often predisposed by previous injuries or a traumatic experience to the shoulder such as strains and tears in the rotator cuff muscles, or post-operative; whereas the onset for adhesive capsulitis is often idiopathic with no history of shoulder related injuries. External rotation, abduction and internal rotation are often the movements restricted in both cases.

A great way to reduce your risk for developing frozen shoulder or adhesive capsulitis, especially as you age, is to regularly stretch your shoulders and spine, and taking up regular exercises such as yoga. Adhesive capsulitis usually resolves on its own after 2 years and follows 4 stages: pre-freezing, freezing, frozen, thawing. However, the recovery of a frozen shoulder is dependent on whether or not the root of the pathology is addressed as there is usually an underlying biomechanical dysfunction in the shoulder.

In the off-chance that you do develop either one of these two shoulder-related conditions, you can try physiotherapy for shoulder pain in Singapore. A physiotherapist can help address these pathologies by releasing the tightened muscles around the shoulder complex, as well as mobilising the shoulder joint to improve range and reduce pain. Exercises will also be prescribed to help strengthen muscles surrounding the shoulder to help speed up the recovery and correct any compensatory patterns developed prior or during the course of the injury.

Experiencing shoulder pain? Click here to find out more about physiotherapy for shoulder pain relief and how Core Concepts can help