Frozen shoulder, also known as adhesive capsulitis, is a common condition encountered in clinical practice among patients complaining of shoulder problems. It manifests itself in three distinct phases, initially causing severe pain, followed by stiffness and functional impairment, and ultimately gradual recovery. The diagnosis of frozen shoulder is primarily clinical, with physical examination being the only method of diagnosis, and is characterized by loss of both active and passive shoulder mobility. While the majority of cases are idiopathic, some risk factors have been identified, such as diabetes, thyroid disorders, and immobilization. Initial treatment is predominantly conservative and includes analgesics, corticosteroid injections, and physical therapy, depending on the disease phase. Surgery is reserved for exceptional cases and avoided especially in the early stages. Although many aspects of this condition remain mysterious, this article is intended to inform general practitioners about the existence of frozen shoulder, so that they can provide early information to patients, initiate appropriate additional investigations, and begin initial therapeutic measures as soon as possible.
What is already known about the topic?
Adhesive capsulitis was first described by Duplay in 1896. It affects approximately 2-5% of the population, mostly women between the ages of 40 and 60 (1). It is one of the most common reasons for consultation in orthopedic shoulder surgery, often involving patients who have previously seen their general practitioner. It can be primary or secondary to pathologies intrinsic or extrinsic to the shoulder. It is characterized by severe shoulder pain, followed by progressive loss of passive and active mobility, leading to functional impotence. Depending on the stage of the disease, a number of treatments can be proposed to relieve the patient.
What does this article bring up for us?
This article describes the pathology for non-specialists. It provides them with the tools they need to properly manage the patient, provide answers, and initiate treatment. Consultation with a specialist is not necessary, but may be advisable to assist the general practitioner or if intrinsic shoulder pathology is detected. This article also brings our knowledge up to date, particularly with regard to risk factors and treatment methods, which are evolving over time.
Keywords
Frozen shoulder, stiffness, adhesive capsulitis