Original Article

The Prevalence of a Diabetic Condition and Adhesive Capsulitis of the Shoulder

Authors: Connie B. Tighe, MSN, APRN-BC, Ward S. Oakley Jr., MD, MBA

Abstract


Objectives: Adhesive capsulitis is characterized by a progressive and painful loss of shoulder motion of unknown etiology. Previous studies have found the prevalence of adhesive capsulitis to be slightly greater than 2% in the general population. However, the relationship between adhesive capsulitis and diabetes mellitus (DM) is well documented, with the incidence of adhesive capsulitis being two to four times higher in diabetics than in the general population. It affects about 20% of people with diabetes and has been described as the most disabling of the common musculoskeletal manifestations of diabetes.


Methods: Consented patients presenting with adhesive capsulitis reporting no history of DM had blood testing for diabetes and prediabetes. An anonymous database was analyzed for a diabetic condition.


Results: The prevalence of diabetes in patients with adhesive capsulitis was 38.6% (34 of 88). The prevalence of prediabetes was 32.95% (29 of 88). The total prevalence of a diabetic condition in patients with adhesive capsulitis was 71.5% (63 of 88). Previous literature fails to reveal the incidence of newly diagnosed diabetes, 2 of 88 (2%), and prediabetes, 25 of 88 (28.4%) in patients presenting with adhesive capsulitis. Early diagnosis and effective management of DM reduces the risk of microvascular complications. DM is believed to play a role in the development of musculoskeletal complications.


Conclusions: Awareness of these findings alerts the practitioner to the risk of diabetes and prediabetes in patients presenting with adhesive capsulitis of the shoulder.



This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Smith LL, Burnett SP, McNeil JD. Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med 2003;37:30–38.
 
2. Galatz LM, Neviaser RJ. The frozen shoulder, in Wulker N, Mansat M, Fu F (eds): Shoulder Surgery: An Illustrated Textbook. London, M Dunitz, 2001, pp 317–329.
 
3. Hannafin JA, Chiaia TA. Adhesive capsulitis: a treatment approach. Clin Orthop Relat Res 2000;1:95–109.
 
4. Balci N, Balci MK, Tuzuner S. Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications. J Diabetes Complications 1999;13:135–140.
 
5. Chambler AFW, Carr AJ. The role of surgery in frozen shoulder. J Bone Joint Surg Br 2003;85:789–795.
 
6. Noel E, Thomas T, Schaeverbeke T, et al. Frozen shoulder. Joint Bone Spine 2000;67:393–400.
 
7. Kordella T. Frozen shoulder and diabetes. Frozen shoulder affects 20 percent of people with diabetes. Proper treatment can help you work through it. Diabetes Forecast 2002;55:60–64.
 
8. Arkkila PET, Gautier JF. Musculoskeletal disorders in diabetes mellitus: an update. Best Pract Res Clin Rheumatol 2003;17:945–970.
 
9. Position statement: screening for type 2 diabetes, American Diabetes Association. Diabetes Care 2004;27(suppl 1):S11–S14.
 
10. Lequesne M, Dang N, Bensasson M, et al. Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder-hand syndrome. Scand J Rheumatol 1977;6:53–56.
 
11. Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis: a prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am 2000;82:1398–1407.
 
12. Pal B, Anderson J, Dick WC, et al. Limitation of joint mobility and shoulder capsulitis in insulin-and non-insulin-dependent diabetes mellitus. Br J Rheumatol 1986;25:147–151.
 
13. Neviaser JS. Adhesive capsulitis of the shoulder: the frozen shoulder. Med Times 1962;90:783–807.
 
14. Rodeo SA, Hannafin JA, Tom J, et al. Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 1997;15:427–436.
 
15. Galarraga B. Adhesive capsulitis of the shoulder: a review article. CPD Rheumatol 2002;3:54–58.
 
16. Warner JJP. Frozen shoulder: diagnosis and management. J Am Acad Orthop Surg 1997;5:130–140.
 
17. Zuckerman JD, Cuomo F. Frozen shoulder, in Matsen FA, Fu FH, Hawkins RJ (eds): The Shoulder: A Balance of Mobility and Stability. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1993, pp 253–267.
 
18. Neviaser RJ, Neviaser TJ. The frozen shoulder: diagnosis and management. Clin Orthop Relat Res 1987;223:59–64.
 
19. Cagliero E, Apruzzese W, Perlmutter GS, et al. Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 2002;112:487–490.
 
20. Brigman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 1972;31:69–71.
 
21. Arkkila PET, Kantola IM, Viikari JSA, et al. Shoulder capsultitis in type I and II diabetic patients: association with diabetic complications and related diseases. Ann Rheum Dis 1996;55:907–914.
 
22. Massoud SN, Pearse EO, Levy O, et al. Operative management of the frozen shoulder in patients with diabetes. J Shoulder Elbow Surg 2002;11:609–613.
 
23. Moren-Hybbinette I, Moritz U, Schersten B. The clinical picture of the painful diabetic shoulder: natural history, social consequences and analysis of concomitant hand syndrome. Acta Med Scand 1987;221:73–82.
 
24. Ogilvie-Harris DJ, Fitsialos DP, MacKay M. The resistant frozen shoulder: manipulation versus arthroscopic release. Clin Orthop Relat Res 1995;319:238–248.
 
25. Ealovega MW, Tabaei BP, Brandle M, et al. Opportunistic screening for diabetes in routine clinical practice. Diabetes Care 2004;27:9–12.
 
26. Kim RP. The musculoskeletal complications of diabetes. Curr Diab Rep 2002;2:49–52.