[1] It is a common shoulder ailment that is marked by pain and a loss of range of motion, particularly in external rotation.

Adhesive capsulitis was five times more common in diabetic patients than in the control group, according to a meta-analysis published in 2016.

[1] While a number of treatments, such as NSAIDs, physical therapy, steroids, and injecting the shoulder at high pressure, may be tried, it is unclear what is best.

An important symptom of adhesive capsulitis is the severity of stiffness that often makes it nearly impossible to carry out simple arm movements.

Risk factors for secondary adhesive capsulitis include injury or surgery leading to prolonged immobility.

[citation needed] Adhesive capsulitis is called secondary when it develops after an injury or surgery to the shoulder.

[citation needed] The underlying pathophysiology is incompletely understood, but is generally accepted to have both inflammatory and fibrotic components.

In addition, the coracohumeral ligament attributes to the limitation of internal rotation considering its connection to the supraspinatus and subscapular tendons.

[16] A finding on ultrasound associated with adhesive capsulitis is hypoechoic material surrounding the long head of the biceps tendon at the rotator interval, reflecting fibrosis.

[17] Grey-scale ultrasound can play a key role in timely diagnosis of adhesive capsulitis due to its high sensitivity and specificity.

Thickening in the coracohumeral ligament, inferior capsule/ axillary recess capsule, and rotator interval abnormality, as well as restriction in range of motion in the shoulder can be detected using ultrasound.

Downward rotation and depression are restricted due to the tightness of the rhomboids, upper trapezius and the superior capsule.

[21] Research in the UK showed that there were three typical approaches to treatment (physiotherapy, manipulation of the shoulder under general anaesthesia, and surgery (arthroscopic capsular release)).

[22][23] The effects of most treatments are primarily short-term, focusing on alleviating symptoms such as shoulder pain and reduced joint movement.

Common treatments include exercise, physical therapy, oral analgesics such as paracetamol and NSAIDs, and intra-articular corticosteroid injections.

Oral steroids may provide short-term benefits in range of movement and pain but have side effects such as hyperglycemia.

When using intra-articular corticosteroid injections, the effects of exercise on short-term relief were not significant, although individual studies found some benefits.

[20] Extracorporeal shock wave therapy (ESWT) has been strongly recommended as a way of reducing pain levels and improving range of motion and functioning in people with Stage 2 and 3 adhesive capsulitis of the shoulder.

Laser therapy was also found to have these similar effects for people dealing with Stage 2 adhesive capsulitis.

However, some studies show that arthrographic distension may play a positive role in reducing pain and improve range of movement and function.

Muscle groups such as serratus anterior, trapezius, and rhomboid major/minor need to be strengthened to allow for shoulder function.

Surgery to cut the adhesions (capsular release) may be indicated in prolonged and severe cases; the procedure is usually performed by arthroscopy.

Surgical evaluation of other problems with the shoulder, e.g., subacromial bursitis or rotator cuff tear, may be needed.

This technique allows the surgeon to find and correct the underlying cause of restricted shoulder movement such as contracture of coracohumeral ligament and rotator interval.

The most common surgical technique is arthroscopic capsular release surgery, and it is beneficial to individuals who do not get better with physical therapy treatment.

Starting out with rehabilitation there is an emphasis on range of motion exercises such as passive and active assisted which provides mobility to the joints while preventing further stress/damage to the tissues healing.

Once the strengthening phase is complete, the individual gets reintroduced gradually to activities of daily living and prior training goals.

[28] Following breast surgery, some known complications include loss of shoulder range of motion (ROM) and reduced functional mobility in the involved arm.