Frozen shoulder, or adhesive capsulitis, is more common in Malaysians age 40 to 70 years. People with frozen shoulder normally present with sudden onset of shoulder and arm pain without a history of injury or trauma. Patients normally complain of shoulder pain that can extend into the arm region. The local shoulder pain can present over the front and inner part of the shoulder and radiates into the biceps region or over the outer part of the shoulder and radiates into the lateral deltoid region. There is a marked loss of both active and passive range of motion of the shoulder, with at least 50% loss of external rotation.
Frozen shoulder is classically divided into 3 different stages:
- Freezing (sudden onset of diffuse shoulder pain with progressive loss of shoulder range of motion)
- Frozen (the pain subsides gradually, however the stiffness in the shoulder remains, restricted motion in both active and passive movements)
- Thawing (gradual resolution of symptoms and improvement of the marked stiffness in the shoulder)
There is no external cause or preceding shoulder condition to a “true” primary frozen shoulder. There is no systemic diagnosis, precipitating shoulder injury or diagnostic imaging to explain this sudden painful shoulder with significant restriction of the range of movement. However, there may be positive results with arthroscopic and histologic studies of the shoulder. These studies may show evidence of glenohumeral capsular contraction, especially the coracohumeral ligament within the rotator interval. This condition is thought to be self-limiting, however, physiotherapy and chiropractic treatment can help to alleviate the shoulder pain and restore shoulder range of movement. Treatment for frozen shoulder in Malaysia can help to prevent residual symptoms and pain with loss of function of the shoulder joint in the future.