The shoulder joint normally has more range of motion than any other joint in the body. When one has adhesive capsulitis, the range of motion of the shoulder joint is severely limited. Individuals who have a frozen shoulder may not even be able to fully dress themselves due to the pain involved in trying to move the affected shoulder.
How does the doctor diagnose adhesive capsulitis?
The doctor will start by taking a history of your shoulder pain. Your doctor will ask you when you noticed the pain in your shoulder, and did the pain stop you from using your shoulder. Prior to examining you, your doctor may ask you if you can move your shoulder at all. Then after observing your active range of motion, your doctor may try passive range of motion.
Evaluating range of motion – To be able to evaluate the condition of your shoulder, your doctor will ask you to relax your arm and shoulder completely. The doctor will then attempt to move your shoulder into different positions. Your doctor will observe your pain response to the passive shoulder movements, and he/she will also evaluate the stiffness in the joint.
The doctor is likely only going to be able to move the shoulder joint a few degrees if the shoulder is frozen. If the joint is healthy the shoulder should be able to be flexed (moved forward where the arm is above the head) 90 degrees, and extended (moved so that the arm is in back of the body) 50 degrees. The shoulder should be able to be abducted (moved away from the midline of the body) by 90 degrees. Conversely, the shoulder should be able to be adducted (moved toward the midline of the body) by 90 degrees. This means to move the shoulder away from 0 degrees to 90 degrees and to move the shoulder toward the center of the body from 90 degrees to 0 degrees. Knowing what the normal range of motion is for different shoulder and arm positions, your doctor will be able to assess the degree of immobility to your shoulder joint.
X-ray and/or MRI (Magnetic Resonance Imaging) – Your doctor may order some X-rays and/or an MRI to confirm or deny the presence of other structural problems within the shoulder that may be causing the pain and immobility of the shoulder.
Arthrogram – To rule out other possible conditions that may be causing the symptoms of a frozen shoulder, your doctor may order an arthrogram. An arthrogram is a special kind of X-ray, in which a contrast medium is injected into your shoulder. An arthrogram is helpful in identifying conditions such as a torn rotator cuff. If the rotator cuff tendon is torn, the contrast medium will leak into an area that it shouldn’t; the contrast medium may also show a blockage due to some kind of trauma, swelling, or disease process going on in the shoulder.
Conclusion
Adhesive capsulitis can happen in stages. At first you might notice pain in your shoulder, and you may be able to move the joint, even though it hurts to do so. The pain is likely to be caused by swelling and inflammation. As time progresses the range of motion of the joint decreases as the capsule shrinks around the joint. The pain and discomfort associated with adhesive capsulitis will likely send anyone to the doctor, no matter what their pain tolerance might be. If you have injured your shoulder see a doctor right away to evaluate your injury. If you haven’t injured your shoulder, but you have significant pain and limited movement in your shoulder, see your doctor within the first 24 to 48 hours after the onset of your symptoms.
It is important to let a medical professional evaluate your shoulder to identify the problem. The advantage of an early diagnosis is that you can be properly treated to relieve pain and regain shoulder mobility.
Sources:
http://en.wikipedia.org/wiki/Shoulder_problems
http://www.medic8.com/healthguide/articles/painfulshoulder.html
http://orthoinfo.aaos.org/topic.cfm?topic=A00071
http://www.merck.com/mmpe/sec22/ch336/ch336b.html?qt=range%20of%20motion&alt=sh#S21_CH336_T001
