Adhesive capsulitis of the shoulder: pain intensity and distribution

Abstract

Purpose

Papers regarding adhesive capsulitis (AC) of the shoulder focused on etiology, epidemiology, diagnosis, and treatment; until now, information on shoulder pain characteristics is still scarce. Our aim was to analyze pain intensity and distribution in patients with AC.

Methods

The study group was composed of 278 (133M–145F) consecutive patients with AC. After diagnosis, shoulder pain distribution was assessed through an upper limb pain map and pain intensity through a visual analog scale. Patients were distinguished on the basis of gender, age, time elapsed from onset of symptoms, and severity of functional limitation. Data were submitted to statistical analysis.

Results

Intensity of shoulder pain caused by AC was higher in females (p < 0.05); it did not vary with the side and between patient younger and older than 55 years. Patients whose pain arose from more than 3 months suffered a lower intensity of shoulder pain. Furthermore, pain intensity was higher in the most severe form of AC (active forward flexion < 60°) (p < 0.05). Pain was localized predominantly on the anterior aspect of the shoulder (dermatomes C5–C6) and rarely extended beyond the distal third of the arm. No differences were found in pain distribution between male and female, between patients with pain from less or more than 3 months and between different levels of AC severity (p > 0.05).

Conclusion

Shoulder pain due to AC may be influenced by gender and severity of functional limitation. AC pain distribution principally involves anterior aspect of the shoulder with downward extension of the arm until its distal third.

Levels of evidence

Level IV.

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Correspondence to V. Candela.

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All authors declared that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study. All patients signed an informed consent form in accordance with the Declaration of Helsinki. According to our Country’s law, this study did not require an ethics committee approval.

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Candela, V., Giannicola, G., Passaretti, D. et al. Adhesive capsulitis of the shoulder: pain intensity and distribution. Musculoskelet Surg 101, 153–158 (2017). https://doi.org/10.1007/s12306-017-0488-6

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Keywords

  • Adhesive capsulitis
  • Shoulder pain
  • Pain intensity
  • Shoulder pain distribution
  • Frozen shoulder
  • Shoulder clinical evaluation