Information about conditions is provided as a service to our patients for educational purposes only. "If you understand your condition, you will be able to do the things necessary to rehabilitate much faster." Please feel free to print the information so that you can refer to it often. Sharing of information is quite risky, however. Do not presume that information is meant for you if you have not seen the doctor and received a specific diagnosis. Some conditions share similar symptoms but require very different treatment. If you have friends or family who may have similar symptoms, please schedule an appointment to see the doctor.

Frozen Shoulder
(Adhesive Capsulitis)

Adhesive capsulitis is a perplexing shoulder disorder that is both well recognized and controversial. It is characterized by prominent reduction in the glenohumeral range of movement." Adhesive capsulitis has typically been classified into two forms, primary and secondary. In the primary or idiopathic form, no known precipitating event can be identified. The secondary form is associated with or attributable to other illnesses or events. Although in many cases the clinical disorder in the two types appears to be similar, there also can be important differences.

For clarity, only the idiopathic form will be discussed. The complexity of the condition stems from the complex nature of the shoulder joint itself. Note the many layers and various ligaments shown. The space shown around the joint is a very large circle and has a great deal of surface. This contributes to the adhesions that form anywhere along that surface.

Treatment and Rehabilitation

  1. Physical therapy of the shoulder joint, supporting muscles and tissues is critical for several days at first when treatment begins and then 3 times a week for a few weeks with the onset of exercises Sometimes, Manipulation of the spine and surrounding tissue relieves the stress on the muscle attachments.
  2. Proper exercises begun at the right time will reduce the strain on the muscles and improve function.
  3. Elimination of repetitive friction motions will relieve the symptoms.


  1. For acute situations, utilize ice packs on the affected area until numbness is reached.
  2. Interferential current and Ultrasound therapy is effective in the healing process.
  3. At the appropriate time, stretches and strengthening exercises should be implemented in the treatment regimen.

Treatment frequency is usually daily for 3-7 days and then three times a week for 3-6 weeks. After that, realignment of the vertebra must be performed to prevent eventual return of this condition. It can be accomplished in 30-60 days of reduced frequency management. Often once a week treatment is sufficient at that point to restore alignment. Thereafter, this condition can be reasonably avoided with monthly correction of spinal alignment.

After the first few days of treatment, you will be given a sheet of stretching exercises to do at home. This is to help reduce the treatment time and speed healing. It is very important for you to do these daily as prescribed. If you have any questions about them or difficulty or pain on performing them, please tell the doctor right away.

Several days following the initiation of treatment, more aggressive exercise routines will be proscribed for you. You will be taken to the rehabilitation center and instructed on how to use the computer monitored exercise routines specifically designed for this condition. The routines are monitored for completion and graduated in difficulty after certain numbers of routines have been completed. You will be expected to perform these routines after treatment during the initial part of the restorative phase and throughout the rehabilitative phase of your treatment. Our goal is to help you get well and stay well. We know from experience that most mechanical conditions return gradually over a period of months and become more advanced each time. The only way this can be prevented is with exercise. We expect you to be successful.

We offer treatment of these conditions at various levels for all patients. We expect that you will follow this treatment plan through to its logical conclusion of restoration of complete function and rehabilitation. Our management system is designed to help you remember all of your appointments and to be fully compliant with all of our recommendations. At any time, should you decide to discontinue the process, please just let us know so that we don't become a bother.

LIFE STYLE CHANGES: Long periods of stress should be avoided. Do not sleep or lie on your stomach and avoid activities that hyper extend the neck. Water intake should be increased substantially

SUPPLEMENTATION: Glucoseamine Sulphate and Trace Minerals: These supplements have proven effective in long-term prevention of deterioration of joint tissues and the disc. This may help reduce the mechanical breakdown associated with three joint complex problems.

HOME REMEDIES AND RECOMMENDATIONS: Utilize ice packs on the neck back for 10 minutes at a time and moist heat packs on the muscles of the upper back at 20 minutes at a time, not simultaneously and not more often than once per hour. This should continue until the arm pain or numbness disappears. Hot tubs provide buoyancy and may be used after 5 days of onset for temporary relief.


We understand that you have come here for help. We have spent many years learning the best ways to solve the problems of mechanical back and neck pain. We expect you to comply with our recommendations and follow our treatment schedule completely regardless of the treatment plan you have. We expect you to set all of the recommended appointments at times convenient for you and we expect you to keep all of them. We expect you to respond favorably and know that your 100% compliance is the determining factor. We also expect you to attend our next class on Absolute Spinal Health. The staff can give you a schedule of the next class.

Other Information: At our class on Absolute Spinal Health, we discuss mechanical conditions of the back, neck and spine and teach you ways to prevent mechanical conditions from occurring. We also offer a wide variety of health information at our web site. All patients are welcome to use our information to improve your life and maintenance your spinal health.

Maintenance: Regular spinal adjustments are important to reduce the symptoms of bursitis. Patients who receive monthly spinal manipulation and therapy report fewer complications with bursitis. It is important that you follow your physician's advice about the frequency of treatment for your particular condition.

Holladay Physical Medicine - 4211 Holladay Blvd. Salt Lake City, UT - 801-272-8471 Please read the Disclaimer