Introduction
Adhesive capsulitis, also known as frozen shoulder or periarthritis, affects between 2% (Baums et al. 2007) to 5 % of the adult population (Blanchard, Barr & Cerisola ; Kisner 2002) and 10-20% of cases from people suffering from Insulin Dependent Diabetes Mellitus (Buchbinder et al. 2008). Adhesive Capsulitis is the idiopathic spontaneous onset of glenohumeral pain and capsular stiffness (Blanchard, Barr & Cerisola 2010). It is a self-limiting disorder (Baums et al. 2007) where adhesions restrict capsular extensibility (Kisner 2002) first reducing rotation range, then abduction and finally flexion. (Kivimaki & Pohjolainen 2001).
_The aetiology of Adhesive Capsulitis is broad and generally unknown.
The research presents with many specific pathology theories and limited specificity on a single cause. The insidious onset usually occurs between the ages of 40 and 60 years, and is separated into two categories. In primary frozen shoulder, the pathogenesis extends from chronic inflammation of musculotendinous or synovial tissue such as the rotator interval-capsule/coracohumeral-ligament-complex (Baums et al. 2007), biceps tendon, or joint capsule. This results in the formation of capsular thickening and adhesions, particularly in the folds of the inferior capsule (Kisner 2002). In secondary, shoulder movement restictions may be limited by past pain or structural insufficiencies due to existing pathologies such as osteoarthritis, rheumatoid arthritis, trauma or immobilization (Kisner 2002). |