Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, causes pain, stiffness and a progressive loss of movement in the shoulder joint. The condition develops when the capsule surrounding the shoulder becomes inflamed, thickened and tight, making normal shoulder movement increasingly difficult.
What Is Frozen Shoulder?
The shoulder is surrounded by a flexible capsule of connective tissue that helps stabilize the joint while allowing a wide range of motion. With adhesive capsulitis, this capsule becomes thick and tight, restricting shoulder movement and causing pain and stiffness.
A Condition That Develops Over Time
Frozen shoulder typically develops gradually and may take months or longer to fully resolve. Symptoms often progress through recognizable stages, beginning with increasing pain and followed by significant stiffness before shoulder mobility slowly improves.
How Frozen Shoulder Progresses
Adhesive capsulitis commonly develops in three overlapping stages. The duration and severity of each stage can vary considerably from one patient to another.
The Freezing Stage
Shoulder pain gradually increases and movement becomes more difficult. Patients may begin avoiding certain movements because of discomfort, and range of motion can progressively decrease. Nighttime pain is often especially noticeable during this stage.
The Frozen Stage
Pain may begin to decrease, but stiffness often becomes the dominant problem. Reaching overhead, reaching behind the back, dressing and performing other everyday movements may become increasingly difficult.
The Thawing Stage
Shoulder mobility gradually begins to return. Range of motion may improve slowly over several months as stiffness decreases and the shoulder becomes easier to use during normal activities.
How Frozen Shoulder May Affect You
Pain and restricted movement are the defining symptoms, but the condition can also interfere significantly with sleep and everyday activities.
Common Symptoms May Include:
Who Is More Likely to Develop Frozen Shoulder?
Adhesive capsulitis can occur without an obvious cause, but several factors are associated with a higher risk.
Age & Sex
Frozen shoulder occurs most often in middle-aged adults and is more commonly diagnosed in women.
Prolonged Immobility
Keeping the shoulder relatively still after injury, surgery or illness can increase the risk of developing adhesive capsulitis.
Diabetes
People with diabetes have an increased risk of frozen shoulder and may experience more persistent stiffness.
Other Medical Conditions
Thyroid disorders and certain neurological or systemic conditions may also be associated with an increased risk of frozen shoulder.
How Frozen Shoulder Is Diagnosed
Diagnosis is often based on the characteristic pattern of pain and restricted motion along with a physical examination.
Your provider will review when symptoms began, previous injuries, surgery, medical conditions and changes in shoulder use.
Both active movement and passive movement of the shoulder are assessed to determine the degree and pattern of restriction.
X-rays, ultrasound or MRI may be used when necessary to rule out arthritis, rotator cuff injuries or other causes of shoulder pain.
Treating Frozen Shoulder
Treatment typically focuses on controlling pain while gradually restoring shoulder mobility and function.
Physical Therapy
Guided stretching and range-of-motion exercises can help preserve and gradually restore movement while avoiding excessive irritation.
Pain Medication
Anti-inflammatory or other pain medications may be recommended when appropriate to help control pain during recovery.
Shoulder Injections
Corticosteroid and local anesthetic injections may be considered to help reduce inflammation and pain, particularly during the painful early stage.
Advanced Treatment
When severe stiffness persists despite conservative care, manipulation under anesthesia or arthroscopic capsular release may be considered in selected patients.
Keeping the Shoulder Moving Is an Important Part of Recovery.
Frozen shoulder can eventually improve, but significant stiffness may persist for many months. Appropriate treatment can help control pain and maintain movement while the condition progresses through its stages. A supervised rehabilitation program is especially important because overly aggressive stretching may worsen symptoms in some phases of the condition.
Is Shoulder Pain Making It Difficult to Move Your Arm?
Schedule an evaluation to determine whether frozen shoulder may be causing your pain and restricted range of motion.