Adhesive capsulitis in workers with shoulder injury: prevalence, characteristics and risk factors

Background: The objectives of this study were to report the prevalence of adhesive capsulitis (AC) in injured workers seen at an Early Shoulder Physician Assessment (ESPA) Program and to explore patient characteristics and risk factors associated with this condition. Methods and Findings: This study involved a review of the electronic files of injured workers who were referred to an early assessment program within the 16 weeks of the injury or recurrence. The measure of disability was the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH). Data of 1000 consecutive patients, 443 (44%) females, 557(56%) males, (mean age=49, SD=11) were reviewed. Seventy eight (8%) patients were diagnosed with adhesive capsulitis based on the clinical examination. Risk factors for AC were a higher age (54 vs. 48, p<0.0001) and having a history of diabetes (18% vs. 9%, p=0.01). Sex was not an important factor in the development of the adhesive capsulitis (p=0.92) in the sample studied. Patients suffering from AC reported higher levels of QuickDASH as compared with the rest of the sample (61 vs. 55, p=0.01). However, despite a higher disability, there were no statistically significant differences in the consumption of medication between patients with and without adhesive capsulitis. Conclusions: The prevalence of AC in injured workers with shoulder complaints within the 16 weeks of the injury or recurrence was low at 8%. Considering an older age and presence of diabetes are risk factors for development of AC, patients over age of 50 and those with a history of diabetes mellitus should be monitored more closely, particularly in the early phase of injury or recurrence to ensure an effective and timely management.