The symptoms of adhesive capsulitis are basically intense pain that gradually increases, shoulder stiffness, making the affected person slowly realize that there is an inadequate condition, as they begin to perceive difficulty in performing daily activities.
Symptoms can be divided according to the three phases of adhesive capsulitis: acute or hyperalgic; hardening or freezing and thawing.
The symptoms are listed below according to the phase:
01. The first phase is the acute phase, in which the pain starts to progressively worsen and becomes more and more intense, in this phase it is usually also to present sweating in the hands and armpits, circulatory problem, difficulty in rotating and lateral movements and insomnia.
It lasts for about nine months. 02.The second phase is that of freezing, in which stiffness sets in, the pain decreases in intensity, but continues mainly at night, the stiffness or freezing of the shoulder consists of blocking movement. This phase can last up to a year or more.
03.The last phase is the thawing phase, in which movements become more possible, the shoulder gradually regains the elasticity of the ligaments and the joint capsule, increasing the range of movements. The duration of this phase is extensive, reaching twenty-four months to present this picture of spontaneous improvement.
Causes of Adhesive Capsulitis
The causes of adhesive capsulitis involve trauma to the joints, repetitive or heavy exertion, or due to immobilization of the arm for a long time. Often, however, it can be idiopathic.
Other causal factors, such as genetic factors, immune system reactions, that is, some autoimmune condition such as lupus or sickle cell anemia and other pathological factors, that is, other diseases such as diabetes, hypothyroidism and hyperthyroidism, cervical hernia, arthrosis, osteonecrosis, fractures.
About 20% of diabetes cases have adhesive capsulitis.There are hypotheses that adhesive capsulitis is caused by synovitis, which consists of an inflammation of the synovial membrane, which is also located in the joints.
Adhesive capsulitis starts with inflammation in the capsule, then there is stiffness and difficulty in performing normal movements, finally, there is thawing, which consists of temporarily improving movement.The etiology of adhesive capsulitis, therefore, can be of traumatic origin, due to external factors or intrinsic factors of the shoulder itself, or from other health problems.
It is called idiopathic or primary capsulitis, which does not have a well-defined cause, while secondary capsulitis refers to that which has external or intrinsic causes, such as those previously reported.
Physiologically speaking, it is considered that what occurs in the shoulder freezing process is that blood circulation is impaired due to muscle contraction, preventing nutrients from feeding the shoulder joints, ligaments and blood vessels, which can then cause edema and changes in the connective tissue of the area in question, so the inflammatory process develops together with fibrosis and thus, the joint capsule becomes rigid.
Furthermore, adhesive capsulitis is related to reflex sympathetic dystrophy, that is, in terms of the sympathetic and parasympathetic systems that reflect pain and disability in the shoulder.