Frozen Shoulder (Adhesive Capsulitis)

✅ Definition

A condition characterized by progressive pain, stiffness, and significant loss of both active and passive shoulder range of motion, caused by thickening and contracture of the joint capsule.

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✅ Causes & Risk Factors

• Idiopathic (primary): unknown cause.

• Secondary:

  • Post-trauma or post-surgery.

  • Prolonged immobilization.

  • Associated conditions: Diabetes mellitus, Thyroid disorders, Stroke, Cardiac disease.

• More common in women > 40 years old.

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✅ Stages

1. Freezing (Painful stage):

   • Duration: 2–9 months.

   • Severe pain (especially at night) and gradual restriction of movement.

2. Frozen (Stiff stage):

   • Duration: 4–12 months.

   • Pain decreases, but marked stiffness and limited ROM remain.

3. Thawing (Recovery stage):

   • Duration: 12–42 months.

   • Gradual improvement of ROM and function.

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✅ Clinical Features

• Gradual onset of pain.

• Pain worse at night.

• Marked restriction in both active & passive movements (especially external rotation).

• Difficulty with daily activities (dressing, combing hair, overhead reach).

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✅ Diagnosis

• History & Clinical Examination are the main tools.

• Imaging (X-ray, MRI) is usually used to exclude other conditions (e.g., rotator cuff tear, arthritis).
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  🔹protocol of treatment