From the Research
Yes, adhesive capsulitis is generally considered a self-limiting disease that typically resolves on its own over time, though the process can be lengthy. Most patients experience complete or near-complete resolution of symptoms within 1-3 years without specific treatment, progressing through three clinical phases: freezing (painful phase, 2-9 months), frozen (stiffness phase, 4-12 months), and thawing (recovery phase, 5-24 months) 1. Despite its self-limiting nature, treatment is often recommended to manage pain and accelerate recovery.
Treatment Options
Conservative approaches include:
- Physical therapy with stretching exercises
- NSAIDs like ibuprofen (400-800mg three times daily) for pain
- Occasionally corticosteroid injections For persistent cases, more invasive options include:
- Hydrodilatation
- Manipulation under anesthesia
- Arthroscopic capsular release 1.
Disease Progression and Treatment
The condition results from inflammation and subsequent fibrosis of the shoulder capsule, leading to characteristic pain and restricted range of motion. While most cases resolve spontaneously, treatment can significantly reduce the duration and severity of symptoms, improving quality of life during the recovery period. Recent evidence suggests that persistent functional limitations can occur if left untreated, challenging the traditional view of adhesive capsulitis as a self-limiting condition with full resolution of symptoms without treatment 1.
Current Evidence and Recommendations
The most effective treatment for adhesive capsulitis is uncertain, but physiotherapy and corticosteroid injections combined may provide greater improvement than physiotherapy alone 1. It is essential to consider the patient's symptoms, stage of the condition, and recognition of different patterns of motion loss when selecting a physical treatment method for adhesive capsulitis 2. Guidelines for clinical assessment should be presented in this scoping review.
Key Considerations
- Adhesive capsulitis is predominantly an idiopathic condition with an increased prevalence in patients with diabetes mellitus and hypothyroidism 1.
- Imaging is not necessary to make the diagnosis, but a finding of coracohumeral ligament thickening on noncontrast magnetic resonance imaging yields high specificity for adhesive capsulitis 1.
- Surgical treatment options, such as manipulation under anesthesia and arthroscopic capsule release, are considered for patients who have minimal improvement after six to 12 weeks of nonsurgical treatment 1.