Frozen joint syndrome (Adhesive capsulitis)

Frozen joint syndrome, technically known as adhesive capsulitis, is a painful disorder that results from the chronic inflammation, scarring, thickening and shrinkage of the capsule that surrounds the involved joint, classically occurring in the shoulders or knees.

What are the causes?
The syndrome is often seen following prolonged immobilization (or markedly reduced motion) of the affected joint, especially after extensive surgery.  Fibrous bands of tissue, called adhesions, develop between the immobilized joint surfaces. A decrease in the joint’s natural lubricant, synovial fluid, may also contribute to loss of function.

What treatment options are available?
The good news is that this disorder is largely curable.  Excellent pain management is a must, accompanied by graded physical therapy with increasing range of motion of the affected joint. Sometimes the pain of therapy responds to a simple combination of oral and topical analgesics; however, joint anesthetic injections prior to therapy sessions, and even continuous anesthetic blockade, may be necessary to yield a level of comfort required to exercise.

In extreme cases, an orthopedic surgeon can under general anesthesia carefully, yet forcefully, move the joint to break the adhesions. This procedure must be followed up with regular therapy to prevent reformation of the pesky adhesions.

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