Hey guys,
What’s your experience with adhesive capsulitis or frozen shoulder? Are these cases worth taking on?
My question comes after consulting a 44 y/o F with the presenting complaint of “shoulder mobility issues”. It started 3 months ago and hasn’t gotten worse or particularly better. There hasn’t been any pain so far just a lack of mobility – so she can’t rate it.
She has developed a bit of neck pain. Described as an ache in the bilateral lwoer neck, lower severity 2/10.
Aggravating: overhead work is difficult, lounging around, sitting positions
Relieving: Thai Chi, swinging the arms more with walking, stretching (but has been afraid of doing this.
GHAbd: <90 degrees – I can’t believe theres no pain. I can palpate adhesion in infraspinatus and teres minor, but can’t really get enough mobility to test subscap and capsule.
I’ve started her on some general mobility movements to try to prevent her from becoming any more fear avoidant.
Should I get an MRI? I feel like that lack of pain in this case makes it hard to be caused by any serious pathology like infection or tumour. It seems like a stock standard frozen shoulder to me.
So basically should I take this patient on? Or is it going to be a train wreck of no improvement and disappointment for all involved?