Stage 1 adhesive capsulitis is characterized by which pattern?

Stage 1 adhesive capsulitis is characterized by which pattern?

• A. 0-3 months; sharp pain at end of ROM; sleep disturbance; early loss of ER; intact RTC
• B. 9-12 months; gradual improvement; ROM normal
• C. 3-9 months; frozen with minimal pain
• D. 6-12 months; rapid ROM recovery with no pain

Answer: (A)

This question tests the onset and classic presenting pattern of the early painful phase of adhesive capsulitis. In the initial stage, typically lasting 0–3 months, the shoulder hurts mainly with movement at the end of the available ROM. This end-range pain is often sharp and is frequently worse at night, disturbing sleep. Despite the pain, the rotator cuff remains intact, and there isn’t a major loss of ROM yet—the limiting feature is pain-driven movement rather than severe stiffness. This combination—short duration, end-range pain, sleep disturbance from nocturnal pain, and early loss of external rotation with a normally functioning rotator cuff—best matches the first stage. The other descriptions align with later phases: ongoing or increasing stiffness with longer duration, or a thawing pattern with ROM recovering after a period of stiffness, which do not reflect the initial painful phase.

This question tests the onset and classic presenting pattern of the early painful phase of adhesive capsulitis. In the initial stage, typically lasting 0–3 months, the shoulder hurts mainly with movement at the end of the available ROM. This end-range pain is often sharp and is frequently worse at night, disturbing sleep. Despite the pain, the rotator cuff remains intact, and there isn’t a major loss of ROM yet—the limiting feature is pain-driven movement rather than severe stiffness. This combination—short duration, end-range pain, sleep disturbance from nocturnal pain, and early loss of external rotation with a normally functioning rotator cuff—best matches the first stage. The other descriptions align with later phases: ongoing or increasing stiffness with longer duration, or a thawing pattern with ROM recovering after a period of stiffness, which do not reflect the initial painful phase.