Q.I am a 43-year-old woman in good health. I started having pain in my shoulder that progressed to loss of range of motion. My orthopedist said I had rotator cuff tendinitis and sent me to physical therapy.

After three weeks without improvement, I got a shot in the shoulder that helped for a week. After three more weeks of physical therapy, I went back for a checkup and found I had lost more range of motion.

The doctor now says I have adhesive capsulitis. What is this, and how does it happen? I did not injure the shoulder by any physical activity — it just started hurting. I am to begin aggressive range-of-motion therapy. Is this the best plan? I have only had one X-ray and no MRI.

T.P.

A.Adhesive capsulitis involves shrinkage of the capsule of the shoulder, which results in limited range of motion. Initially when a patient comes to me with shoulder pain, I take a detailed history, perform a physical examination and often take X-rays.

Apparently your orthopedist initially thought you had rotator cuff tendinitis. The rotator cuff is a group of four muscles that surrounds the shoulder joint, forming a cuff that aids in range of motion of the shoulder and helps provide stability. If you did have rotator cuff tendinitis, physical therapy is an appropriate first step.

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