Adhesive capsulitis, also known as a frozen shoulder, is characterized by a painful, gradual loss of active and passive shoulder motion resulting from fibrosis and contracture of the joint capsule (1) [1]. Although other shoulder conditions can result in similar symptoms, people with hyperthyroidism are more prone to developing a frozen shoulder. As a result, if you have hyperthyroidism and are experiencing moderate to severe pain in one or both shoulders that isn’t due to a traumatic injury, then it’s possible that you have adhesive capsulitis as a result of your condition.
Adhesive capsulitis usually develops one of two ways. The primary method is gradual, which usually is the case with those who have hyperthyroidism. But it can also develop as a result of a trauma. When it’s not caused by a trauma, it can take a few weeks or months until the pain is severe enough for the person to seek medical attention. Sometimes they will only notice the shoulder pain initially, but over time they will realize that it’s also affecting their range of motion.
Adhesive Capsulitis Can Be Present In Other Conditions
Although hyperthyroidism is one of the more common conditions in which people develop a frozen shoulder, there can be other conditions that lead to this as well. This includes hypothyroidism, as well as hypoadrenalism, Parkinson’s disease, cardiac disease, pulmonary disease, and stroke (2) [2].
The Three Clinical Phases of Adhesive Capsulitis
The literature discusses three distinct phases of adhesive capsulitis (3) [2]:
1. The freezing or painful stage. This is what I described above, as over time the pain will increase, and both the active and passive range of motion will decrease. This phase typically lasts between 3 and 9 months and is characterized by an acute synovitis (inflammation of the synovial membranes) of the glenohumeral joint of the shoulder (3) [2].
2. The frozen or transitional stage. This stage can last from 4 to 12 months, and it’s usually when the pain is the most intense and the shoulder is the most restricted.
3. The thawing stage. This is when the pain begins to decrease and the range of motion begins to improve. This stage can last anywhere from 12 to 42 months (3) [2].
How Is Adhesive Capsulitis Diagnosed?
As for how adhesive capsulitis is diagnosed, it can be challenging initially. A physical examination will reveal both a loss of passive and active range of motion (4) [2]. Many times it is diagnosed by ruling out other conditions, such as a rotator cuff tear, a bone contusion, or osteoarthritis.
What Are The Treatment Options For Adhesive Capsulitis?
The conventional treatment approach usually will begin with either drugs or physical therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help to reduce the inflammation, which in turn might decrease the pain (5) [3] (6) [4]. Prednisone might also benefit some people with adhesive capsulitis, although the benefits seem to be more short term (7) [5]. Cortisone injections are also commonly used and can lead to fast pain relief and an improved range of motion (8) [6] (9) [7], although of course there are potential side effects as well. Sometimes arthroscopic surgery is used for adhesive capsulitis. But in most cases surgery should be a last resort.
I’m more in favor of using natural anti-inflammatory agents, such as higher doses of curcumin, resveratrol, boswellia, and fish oils. However, many times these won’t result in significant relief, and when this is the case, some type of physical therapy can be beneficial. There is some evidence that a combination of bee venom acupuncture and physiotherapy can help with adhesive capsulitis (10) (11) [8]. For those who aren’t familiar with bee venom acupuncture, this is a type of herbal acupuncture that uses bioactive compounds isolated from bee venom, combined with acupuncture. But “standard” acupuncture can also be beneficial for a frozen shoulder. Manipulation of the shoulder can be beneficial (12) [9], and possibly even manipulation of the thoracic spine (13) [10]. And so going to a chiropractor might help, especially if you see a chiropractor that has experience working on extremities. Low-level laser therapy might also help with adhesive capsulitis (14) [11].
In summary, people with hyperthyroidism are more prone to developing a frozen shoulder, which is also known as adhesive capsulitis. Most of these cases develop gradually, although sometimes it can be due to a trauma. Adhesive capsulitis is usually diagnosed by ruling out other conditions. Conventional treatment usually involves NSAIDs, cortisone injections, physical therapy, and in some cases arthroscopic surgery. Although natural anti-inflammatory agents probably won’t help much, acupuncture, manipulation, and low-level laser therapy might be beneficial.