Adhesive capsulitis of the shoulder.

Area of Science:

• Orthopedics
• Sports Medicine
• Physical Therapy

Background:

• Adhesive capsulitis involves painful, progressive loss of shoulder motion.
• Fibrosis and contracture of the joint capsule are characteristic.
• Other shoulder pathologies can mimic adhesive capsulitis, necessitating differential diagnosis.

Purpose of the Study:

• To outline diagnostic clues for differentiating adhesive capsulitis from other stiff, painful shoulder conditions.
• To discuss the controversial natural history of adhesive capsulitis.
• To guide management strategies based on etiology and patient response.

Main Methods:

• Review of clinical presentation, history, and physical examination findings.
• Analysis of treatment approaches, including conservative and surgical interventions.
• Emphasis on differential diagnosis to identify underlying causes of shoulder stiffness.

Main Results:

• Subtle historical and physical examination findings aid in distinguishing adhesive capsulitis.
• Gentle, progressive stretching exercises are the cornerstone of conservative management.
• Surgical intervention is considered for persistent disability after conservative treatment failure.

Conclusions:

• Accurate diagnosis is essential for effective management of adhesive capsulitis.
• Nonsurgical treatment, primarily physical therapy, is successful for most patients.
• Postoperative therapy is crucial to prevent recurrence and maintain shoulder mobility.