WHAT IS ADHESIVE CAPSULITIS OF THE SHOULDER?
Adhesive capsulitis of the shoulder is the official term of a condition that is commonly known as frozen shoulder. This syndrome is characterized by two primary symptoms: (sudden or gradual) pain and limited range of motion of the shoulder -both active and passive- in all directions, leading to the development of muscle atrophy.

WHAT ARE THE SYMPTOMS?
Patients report experiencing pain at night-time, and particularly when laying on the affected arm. Pertaining to the significantly impaired shoulder function, one major complication is the difficulty of rotating the arm – for example the patient being unable to throw a frisbee, bring up the affected arm behind the back or even lift the arm.
The exact causes of adhesive capsulitis of the shoulder remain unclear. Nevertheless, research indicates that this condition might be the result of abnormal cellular activity which leads to inflammation and formation of scar tissue. Clinical manifestations of adhesive capsulitis normally commence with concentrated pain on the deltoid muscle, which as a general rule is followed by apparition of cervical radiculopathy. The majority of patients believe the symptoms to be the result of fatigue or intensive training, and consequently delay a visit to the doctor. There is also the possibility of the orthopedist ‘‘oversighting’’ adhesive capsulitis in cases where shoulder pain is correlated to pathology of the rotator cuff tendon.
Frozen shoulder develops in three stages which may last between 4 to 20 months. During the first stage, the patient experiences pain, as well as a limited abduction and rotation range of motion. During the second stage, pain begins to diminish whereas shoulder stiffness causes restricted abduction and rotation of the shoulder. The third is the rehabilitation stage, followed by gradual improvement of the shoulder range of motion and the regression of pain.

HIGH RISK GROUPS
According to medical bibliography, frozen shoulder, which is additionally an idiopathic disorder, affects almost 2% of the general population between the ages of 40 to 75.  Women suffering from this condition represent 70% of the totality of patients. Moreover, there is strong correlation between frozen shoulder and diabetes (affecting one in five people who suffer from diabetes), hypothyroidism, strokes, cardiac arrest, injuries that require shoulder mobilization for extended periods of time, as well as occupations that require overhead movements for a considerable amount of time. Furthermore, 4% of patients that suffer from adhesive capsulitis of the shoulder have already had rotator cuff repair surgery.

HOW IS ADHESIVE CAPSULITIS OF THE SHOULDER TREATED?
In cases of idiopathic adhesive capsulitis of the shoulder, the majority of patients experience significantly improved symptoms without the employment of any medical treatment whatsoever, or with the help of appropriately prescribed drugs in combination with low-intensity physiotherapy sessions. In cases of patients who experience mild pain and relatively modest shoulder stiffness, cortisone injections are recommended. In the case of chronic shoulder stiffness or if conventional treatment is unsuccessful (usually in post-traumatic or postoperative medical cases), surgical treatment is deemed necessary. During the procedure, arthroscopic breakage of adhesions and capsular release are performed by the surgeon.  Open surgical release is deemed necessary in cases of extensive adhesions or adhesions surrounding the articular capsule of the shoulder.