The main symptoms of adhesive capsulitis arestiffness, pain and decreased range of motion in your shoulder and upper arm.
You will often be unable to lift your arm over your head or away from your body nor will you be able to rotate it inwards; eventually you may not be able to move it at all. The lack of movement in your shoulder joint will interfere with your everyday tasks like getting dressed, driving, working; even completing simple things like reaching behind your back to scratch it. Muscle spasms in your rotator cuff muscles and swelling of your tendons will also limit your ability to move.
Pain is generally experienced over the front and sides of your shoulder and upper arm area (around your deltoid, biceps brachii and rotator cuff muscles) which can radiate down to your elbow and wrist, or around your upper back from your trapezius muscle, because of the restricted joint space. You will experience pain with movement (such as trying to reach across your body) and eventually at rest. However depending on the cause of your adhesive capsulitis, it can be referred from other areas like your neck, heart, diaphragm, liver or spleen.
Weakness in your shoulder, upper arm and back muscles will occur over time from lack of use; this can create an imbalance in your muscle strength (as the stronger muscles have to compensate for the weaker ones) and cause muscular strains and alignment issues.
Many people will experience depression, anxiety and psychological stress because of the secondary effects of the constant pain from adhesive capsulitis over the long term (stop working which leads to financial stress, stop participating in social and sports activities).
Some people have even experienced an increase in body odor as they find it harder to reach and clean their armpit areas. Often there can be changes in your local nerves to your sweat glands.
Progression of Adhesive Capsulitis
Stage 1 – The “Freezing” painful phase
You will experience a slow onset of mild pain in a generalized area of your shoulder that increases with movement and eventually at rest. Inflammation and tenderness around your joint as a result of muscle spasms and scar tissue that binds your shoulder tissues tighter creates stiffness, which will decrease your range of motion. A vicious circle then develops – the lack of shoulder movement (from trying to protect your shoulder and decrease pain) increases scar tissue development, which decreases the space in your capsule and limits your movement, creating even more stiffness. Pain is often worse at night when sleeping and/or lying on your sore side. This phase of adhesive capsulitis can last between 1- 9 months.
Stage 2 – The “Frozen” stiff and adhesive phase
You will often find a little improvement in pain which will ease over time. This will be more localized, with tenderness around the ball of your shoulder joint. As your inflammation starts to decrease, your scar tissue will get worse and harder, which will increase your stiffness and can limit your movement to an entirely “frozen” state. Discomfort will continue to be worse with extreme ranges of movement or at night (interfering with sleep). You will often have as much as 50% less movement than in your other arm and not be able to raise it more than 40 degrees in any direction. This phase of adhesive capsulitis can last between 4 – 12 months
Stage 3 – The “Thawing” and recovery phase
In the last phase, your shoulder pain decreases drastically, and your scar tissue begins to loosen. As a result your stiffness goes away slowly and your full range of shoulder movement returns gradually. External rotation (turning outward) of the upper arm improves first, followed by abduction (moving up and away from the body) and internal rotation (turning inward). This phase of adhesive capsulitis can last between 5 – 36 months.
Surgery may be required if you experience no improvement within 12 – 18 months of following a treatment plan from your doctor.
Should You Seek Medical Attention?
See a doctor immediately if:
- your shoulder is hot and/or extremely swollen
- you have severe pain, numbness and/or a fever
- you cannot lift your arm straight out to the side
- your symptoms prolong for over 2 weeks after trying conservative and home treatments