The most common complication following non-operative management of adhesive capsulitis with a stretching program is decreased range of motion compared to the contralateral side.
Adhesive capsulitis is defined as painful loss of motion of a shoulder without an underlying cause. While it is generally believed to be a self-limiting condition, numerous treatment methods have been suggested including benign neglect, steroid injections, physical therapy, manipulation, and arthroscopic or open capsular releases. Intra-articular steroid injections may provide an earlier return of shoulder range of motion, but have not shown a long-term difference. Non-operative management with a stretching program shows high rates of patient satisfaction, but it is commonly associated with decreased range of motion compared to the contralateral extremity.
Griggs et al. reviewed 75 patients with phase-2 adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 22 months, forward flexion increased by 19 degrees, but still remained 36 degrees less than the unaffected shoulder.
Shaffer et al. reviewed 62 patients with adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 7 years, 60% of patients had decreased range of motion in at least one plane when compared to a control-group of normal shoulders.
Answer 1: While continued pain is a frequent complication, it is usually much improved from the initial onset of the disease and does not affect quality of life.
Answer 3: Adhesive capsulitis is thought to have a low recurrence rate after it has resolved.
Answer 4: Surgical intervention following non-surgical management of adhesive capsulitis is rare since >90% report satisfaction with non-operative treatment.
Answer 5: The association between rotator cuff arthropathy and adhesive capsulitis has not been studied.
Griggs SM, Ahn A, Green A: Idiopathic adhesive capsulitis: A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am 2000;82:1398-1407.
PMID:11057467 (Link to Abstract)
Shaffer B, Tibone JE, Kerlan RK: Frozen shoulder: A long-term follow-up. J Bone Joint Surg Am 1992;74:738-746.
PMID:1624489 (Link to Abstract)