Adhesive Capsulitis

Abstract

Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Variable nomenclature, inconsistent reporting of disease staging, and a multitude of different treatments have created a confusing and contradictory body of literature about this condition. Our purpose is to review the evidence for both nonsurgical and surgical management of adhesive capsulitis with an emphasis on level I and II studies when available. Significant deficits in the literature include a paucity of randomized controlled trials, failure to report response to treatment in a stage-based fashion, and an incomplete understanding of the disease's natural course. Recognition that the clinical stages reflect a progression in the underlying pathological changes should guide future treatments.