Kapsulitis

Kapsulitis, commonly known in English as adhesive capsulitis or frozen shoulder, is a condition characterized by inflammation and progressive thickening and tightening of the joint capsule that surrounds the shoulder joint (glenohumeral joint). This leads to pain and a gradual loss of range of motion, particularly external rotation and abduction.

Symptoms typically begin gradually with a dull shoulder ache, worse at night. Over weeks to months, patients develop marked stiffness, making routine movements difficult. In the classic course, three stages are often described: a painful or freezing phase, a stiff or frozen phase, and a gradual thawing or recovery phase.

Although the exact cause is unknown, adhesive capsulitis is associated with diabetes mellitus, thyroid disorders, and other systemic conditions. It can follow an injury or prolonged immobilization of the shoulder, and is more common in people aged 40 to 60 and in women.

Diagnosis is clinical, based on history and physical examination, noting limited active and passive range of motion. Imaging such as X-ray is used to exclude arthritis or rotator cuff problems; MRI or ultrasound may show a thickened, contracted capsule and help assess concomitant pathology.

Most cases improve with time and conservative treatment. Initial management includes physical therapy to restore movement, pain control with NSAIDs, and corticosteroid injections. Hydrodilatation or manipulation under anesthesia can be considered in some cases. Surgical release is reserved for refractory, disabling cases. Recovery spans months to years, with many patients regaining substantial function but some residual stiffness may remain.