ORTHOPEDIC CONCERN

Frozen Shoulder

Also called: frozen shoulder, shoulder pain, rotator cuff, torn shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes increasing pain and stiffness in the shoulder joint. Movement can become significantly restricted, making everyday activities such as dressing, reaching overhead or sleeping comfortably more difficult.

TYPICALLY OCCURS

Inflammation, immobility, injury and certain health conditions

TREATED BY

Shoulder surgery, injections, physiotherapy and pain management

ALSO LINKED TO

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Why it happens?

Frozen shoulder develops when the flexible capsule of connective tissue surrounding the shoulder joint becomes inflamed, thickened and tight. Bands of stiff tissue can develop, and the amount of space available for normal joint movement decreases. This gradually restricts both active movement — when you move your own arm — and passive movement, when someone else attempts to move the shoulder. The process typically produces a combination of pain and progressive stiffness rather than simply discomfort when using the shoulder.

In many cases, there is no obvious reason why frozen shoulder develops. However, it is more likely to occur after a period in which the shoulder has remained relatively immobile. This can happen following an arm or shoulder injury, fracture, surgery or another condition that makes normal shoulder movement difficult or painful. Prolonged restriction of movement can contribute to tightening of the joint capsule, although not everyone who immobilises their shoulder develops the condition.

Certain health conditions are also associated with an increased risk of frozen shoulder. It is particularly more common in people with diabetes and is also associated with some thyroid conditions and other systemic illnesses. Frozen shoulder most frequently affects adults in middle age and tends to progress slowly. Although the condition often eventually improves, the complete process can take many months and sometimes considerably longer, with pain and stiffness changing as it moves through its characteristic stages.

How far along is it?

Early

Shoulder pain gradually increases and movement becomes progressively more difficult. Pain may be particularly noticeable at night, while the range of motion begins to decrease. This phase can last for several months.

Moderate

Pain may begin to reduce, but stiffness becomes the dominant problem. Shoulder movement can be significantly restricted, making reaching, dressing and other everyday activities difficult.

Advanced

Movement gradually begins to return as stiffness improves. Shoulder function can continue recovering over a period of months, although the speed and degree of recovery vary between individuals.

What addresses it?

Treatments that address this

Rotator cuff repair→

It is worth seeking professional assessment when shoulder pain and stiffness persist, gradually worsen or begin limiting everyday movement. Difficulty raising the arm, reaching behind the back, dressing or sleeping because of shoulder symptoms can indicate that further assessment is appropriate.

Frozen shoulder shares symptoms with several other shoulder conditions, so restricted movement should not automatically be assumed to be adhesive capsulitis. Seek prompt medical attention for severe pain following an injury, obvious deformity, sudden inability to move the arm, significant swelling, fever, or shoulder or arm discomfort accompanied by chest pain or breathing difficulties.

Quick Questions:

What are the first signs of frozen shoulder?

Frozen shoulder commonly begins with gradually increasing shoulder pain followed by progressive stiffness. Pain can be worse at night, and movements such as reaching overhead or behind your back may become increasingly difficult.

How long does frozen shoulder last?

Frozen shoulder usually develops and resolves gradually. The complete freezing, frozen and thawing process can take many months and, for some people, a few years. Recovery time varies considerably.

What causes frozen shoulder?

The exact cause is not always known. It can develop without an obvious trigger or following injury, surgery or prolonged shoulder immobility. Diabetes and certain other health conditions are associated with an increased risk.

Can frozen shoulder get better without surgery?

Yes. Many cases improve over time without surgery. Management may include pain relief, physiotherapy, exercises and injections depending on the stage and severity. Surgery or other procedures are generally considered when significant symptoms persist despite appropriate non-surgical management.