ICD-10: M75.00

Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by stiffness and pain in the shoulder joint. The ICD-10 code M75.00 specifically refers to adhesive capsulitis of the unspecified shoulder, indicating that the condition has not been localized to either the right or left shoulder.

Clinical Description

Definition

Adhesive capsulitis is an inflammatory condition that leads to the thickening and tightening of the shoulder capsule, which is the connective tissue surrounding the shoulder joint. This results in restricted movement and significant discomfort, particularly during shoulder movements.

Symptoms

Patients with adhesive capsulitis typically experience:
- Pain: Often a dull ache that can become sharp with certain movements.
- Stiffness: A gradual loss of range of motion, making it difficult to perform everyday activities such as reaching overhead or behind the back.
- Limited Mobility: The inability to move the shoulder freely, which can affect both active and passive movements.

Stages

Adhesive capsulitis generally progresses through three stages:
1. Freezing Stage: Gradual onset of pain and increasing stiffness, lasting from 6 weeks to 9 months.
2. Frozen Stage: Pain may diminish, but stiffness remains, often lasting from 4 to 6 months.
3. Thawing Stage: Gradual return of motion, which can take several months to years.

Diagnosis

Diagnosis of adhesive capsulitis typically involves:
- Clinical Evaluation: A thorough history and physical examination to assess pain levels and range of motion.
- Imaging Studies: While not always necessary, X-rays or MRI may be used to rule out other shoulder conditions.

Treatment Options

Management of adhesive capsulitis may include:
- Physical Therapy: A structured program to improve range of motion and strength.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.
- Corticosteroid Injections: To reduce inflammation and improve mobility.
- Surgery: In severe cases, procedures such as arthroscopic capsular release may be considered.

Prognosis

The prognosis for adhesive capsulitis is generally favorable, with most patients experiencing significant improvement over time, although recovery can take several months to years. Early intervention and adherence to treatment protocols can enhance outcomes.

Conclusion

ICD-10 code M75.00 captures the essence of adhesive capsulitis of the unspecified shoulder, highlighting the need for careful diagnosis and a tailored treatment approach. Understanding the clinical features and management strategies is crucial for healthcare providers to effectively address this common musculoskeletal condition.

Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by stiffness and pain in the shoulder joint. The ICD-10 code M75.00 specifically refers to adhesive capsulitis of the unspecified shoulder. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for accurate diagnosis and effective management.

Clinical Presentation

Definition and Overview

Adhesive capsulitis is a condition where the shoulder capsule becomes inflamed and thickened, leading to restricted movement and significant discomfort. It typically progresses through three stages: freezing, frozen, and thawing, each with distinct characteristics.

Stages of Adhesive Capsulitis

1. Freezing Stage: This initial phase can last from 6 weeks to 9 months, during which patients experience increasing pain and a gradual loss of shoulder mobility.
2. Frozen Stage: Lasting from 4 to 6 months, this stage is marked by a significant reduction in pain but a notable restriction in shoulder movement.
3. Thawing Stage: This final phase can last from 6 months to 2 years, where shoulder mobility gradually improves, and pain diminishes.

Signs and Symptoms

Common Symptoms

• Pain: Patients often report a dull or aching pain in the shoulder, which may radiate down the arm. Pain is typically worse at night and can interfere with sleep.
• Stiffness: A hallmark of adhesive capsulitis is a marked reduction in the range of motion, particularly in external rotation and abduction.
• Functional Limitations: Patients may struggle with daily activities such as reaching overhead, dressing, or lifting objects.

Physical Examination Findings

• Limited Range of Motion: Both active and passive movements are restricted, particularly in external rotation and abduction.
• Tenderness: There may be tenderness around the shoulder joint, especially when palpating the anterior and lateral aspects of the shoulder.
• Muscle Atrophy: In chronic cases, muscle atrophy around the shoulder may be observed due to disuse.

Patient Characteristics

Demographics

• Age: Adhesive capsulitis is most commonly seen in individuals aged 40 to 60 years.
• Gender: Women are more frequently affected than men, with a ratio of approximately 2:1.
• Comorbidities: Patients with diabetes mellitus, thyroid disorders, or previous shoulder injuries are at a higher risk of developing adhesive capsulitis. Studies indicate that up to 30% of individuals with diabetes may experience this condition[1][2].

Risk Factors

• Previous Shoulder Surgery or Injury: History of trauma or surgical procedures involving the shoulder can predispose individuals to adhesive capsulitis.
• Sedentary Lifestyle: Lack of shoulder movement due to inactivity can contribute to the development of this condition.
• Systemic Conditions: Conditions such as cardiovascular disease and autoimmune disorders have also been associated with an increased incidence of adhesive capsulitis[3][4].

Conclusion

Adhesive capsulitis of the unspecified shoulder (ICD-10 code M75.00) presents with a combination of pain, stiffness, and functional limitations, significantly impacting the quality of life. Recognizing the clinical signs and symptoms, along with understanding patient demographics and risk factors, is essential for healthcare providers in diagnosing and managing this condition effectively. Early intervention, including physical therapy and pain management, can help alleviate symptoms and restore shoulder function over time.

References

1. Adhesive Capsulitis - StatPearls - NCBI Bookshelf.
2. Frozen Shoulder (Adhesive Capsulitis): Symptoms & Treatment.
3. Prevalence of and Risk Factors for Adhesive Capsulitis.
4. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis.

Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by stiffness and pain in the shoulder joint. The ICD-10 code M75.00 specifically refers to adhesive capsulitis of the unspecified shoulder. Here are some alternative names and related terms associated with this condition:

Alternative Names

1. Frozen Shoulder: This is the most widely recognized term for adhesive capsulitis, emphasizing the significant loss of shoulder mobility.
2. Shoulder Adhesion: This term highlights the adhesions that form in the shoulder joint capsule, leading to restricted movement.
3. Shoulder Stiffness: A descriptive term that refers to the primary symptom of reduced range of motion in the shoulder.
4. Capsulitis of the Shoulder: This term focuses on the inflammation of the shoulder capsule, which is a key feature of the condition.

Related Terms

1. Primary Adhesive Capsulitis: Refers to cases where the condition arises without an identifiable cause, often linked to idiopathic factors.
2. Secondary Adhesive Capsulitis: This term is used when the condition develops as a result of another underlying issue, such as injury, surgery, or other shoulder conditions.
3. Rotator Cuff Disease: While not synonymous, this term is often associated with shoulder pain and may co-occur with adhesive capsulitis.
4. Shoulder Impingement Syndrome: Another shoulder condition that can be related to or confused with adhesive capsulitis due to overlapping symptoms.
5. Shoulder Pain: A general term that encompasses various conditions affecting the shoulder, including adhesive capsulitis.

Clinical Context

Adhesive capsulitis can be classified into different stages, often referred to as the "freezing," "frozen," and "thawing" stages, which describe the progression of symptoms and mobility over time. Understanding these terms can help in the diagnosis and treatment of the condition, as well as in communicating effectively about it in clinical settings.

In summary, while M75.00 specifically denotes adhesive capsulitis of the unspecified shoulder, the condition is known by various alternative names and related terms that reflect its symptoms, causes, and clinical implications.

Adhesive capsulitis, commonly known as frozen shoulder, is characterized by stiffness and pain in the shoulder joint. The ICD-10 code M75.00 specifically refers to adhesive capsulitis of the unspecified shoulder. The diagnosis of this condition typically involves a combination of clinical evaluation, patient history, and specific diagnostic criteria. Below, we outline the key criteria used for diagnosing adhesive capsulitis.

Clinical Criteria for Diagnosis

1. Patient History

• Symptoms: Patients often report a gradual onset of shoulder pain, which may be accompanied by stiffness. The pain can be more pronounced at night and may limit daily activities.
• Duration: Symptoms typically persist for at least 3 months before a diagnosis is made, as adhesive capsulitis is a progressive condition.

2. Physical Examination

• Range of Motion (ROM): A significant reduction in both active and passive range of motion is a hallmark of adhesive capsulitis. The examination should reveal limitations in shoulder movements, particularly in external rotation, abduction, and flexion.
• Pain Assessment: The presence of pain during shoulder movement, especially at the end of the range, is noted. Pain may also be present at rest in advanced stages.

3. Exclusion of Other Conditions

• Differential Diagnosis: It is crucial to rule out other potential causes of shoulder pain and stiffness, such as rotator cuff tears, shoulder arthritis, or other inflammatory conditions. This may involve imaging studies like X-rays or MRI to assess the shoulder joint and surrounding structures.

4. Imaging Studies

• While imaging is not always necessary for diagnosis, it can be helpful in excluding other conditions. MRI may show thickening of the joint capsule and other signs consistent with adhesive capsulitis.

Diagnostic Criteria Summary

To summarize, the diagnosis of adhesive capsulitis (ICD-10 code M75.00) is based on:
- A history of shoulder pain and stiffness lasting more than 3 months.
- Physical examination revealing significant limitations in shoulder range of motion.
- Exclusion of other shoulder pathologies through clinical evaluation and, if necessary, imaging studies.

Conclusion

Adhesive capsulitis is a condition that requires careful assessment to ensure accurate diagnosis and appropriate management. The criteria outlined above help healthcare providers identify this condition effectively, allowing for timely intervention and treatment strategies to alleviate symptoms and restore shoulder function. If you suspect adhesive capsulitis, consulting a healthcare professional for a thorough evaluation is essential.

Adhesive capsulitis, commonly known as frozen shoulder, is characterized by stiffness and pain in the shoulder joint, significantly limiting mobility. The ICD-10 code M75.00 refers to adhesive capsulitis of an unspecified shoulder. Treatment approaches for this condition typically focus on alleviating pain, restoring mobility, and improving function. Here’s a detailed overview of standard treatment strategies.

Initial Management

1. Physical Therapy

Physical therapy is a cornerstone of treatment for adhesive capsulitis. A physical therapist will design a tailored exercise program that may include:

• Range of Motion Exercises: Gentle stretching and mobility exercises help to gradually restore movement in the shoulder.
• Strengthening Exercises: Once mobility improves, strengthening exercises can help support the shoulder joint and prevent future issues.

2. Pain Management

Managing pain is crucial in the early stages of treatment. Common methods include:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen can help reduce inflammation and alleviate pain.
• Corticosteroid Injections: In some cases, corticosteroid injections into the shoulder joint can provide significant pain relief and reduce inflammation.

Advanced Treatment Options

3. Manipulation Under Anesthesia (MUA)

If conservative treatments fail, manipulation under anesthesia may be considered. This procedure involves:

• Anesthesia Administration: The patient is sedated to minimize discomfort.
• Shoulder Manipulation: The physician gently manipulates the shoulder to break up adhesions and improve range of motion.

4. Surgical Intervention

In severe cases where other treatments have not provided relief, surgical options may be explored:

• Arthroscopic Surgery: This minimally invasive procedure involves the removal of scar tissue and adhesions from the shoulder joint, allowing for improved mobility.

Rehabilitation Post-Treatment

5. Continued Physical Therapy

Post-treatment rehabilitation is essential for recovery. This phase may include:

• Progressive Exercise Regimen: Gradually increasing the intensity and complexity of exercises to restore full function.
• Education on Activity Modification: Patients are often advised on how to modify daily activities to avoid aggravating the shoulder.

6. Home Exercise Programs

Patients may be provided with a home exercise program to continue their rehabilitation independently, ensuring ongoing improvement in shoulder function.

Conclusion

The treatment of adhesive capsulitis (ICD-10 code M75.00) is multifaceted, often beginning with conservative measures such as physical therapy and pain management. If these approaches are ineffective, more invasive options like manipulation under anesthesia or surgery may be warranted. Continuous rehabilitation is crucial for restoring shoulder function and preventing recurrence. Patients are encouraged to work closely with healthcare providers to develop a personalized treatment plan that addresses their specific needs and goals.