Anatomy: Capsular tissue within the shoulder becomes painfully inflamed and contracts, The problem may occur from minor trauma, overuse, or idiopathically (no identifiable cause)
Diagnosis: The combination of pain, markedly decreased motion and a Grashey X-ray showing the absence of severe arthritis (which is the other diagnosis which can cause severe stiffness and pain) are diagnosistc. MRIs are not necessary and in fact often confuse the diagnosis because the minor rotator cuff damage that is present in most adults can be misinterpreted as the cause of the problem leading to incorrect treatment.
Treatment: Left alone the problem usually resolves spontaneously within two years. However physical therapy for about 6 weeks usually dramatically hastens recovery. If patients have severe pain a cortisone injection into the inflamed tissue will usually substantially alleviate pain, but not usually increase motion.