Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, or adhesive capsulitis, is a disorder associated with pain and stiffness in the shoulder joint. It usually progresses in three stages: developing gradually, worsening with time, and eventually getting better. However, the complete process can span several months to years.

Symptoms

Frozen shoulder is characterized by the following symptoms:

• Pain: Constant shoulder pain that intensifies with movement and may interfere with sleep.
• Stiffness: The shoulder’s reduced range of motion makes it challenging to carry out daily activities.
• Weakness: Because of decreased use, the affected shoulder’s strength is reduced.
• Trouble sleeping: Pain can make it difficult to lie on the affected side, leading to disrupted sleep.

Stages of Frozen Shoulder

Frozen shoulder progresses through three distinct stages:

Freezing Stage (6 weeks to 9 months)

Pain gradually increases, becoming more intense over time. The shoulder’s range of motion decreases as pain intensifies. As a result, those affected may find it hard to carry out daily tasks because of the growing stiffness and discomfort.

Frozen Stage (4 to 12 months)

While the pain may begin to lessen, the shoulder gets considerably stiffer. The reduced range of motion makes it challenging to perform everyday tasks. The stiffness can seriously affect shoulder functionality even as the pain intensity decreases.

Thawing Stage (6 months to 2 years)

During this stage, the range of motion gradually improves. Stiffness decreases, and shoulder functionality begins to get back to normal. Although healing is often a lengthy process, most people regain full mobility and relief from symptoms over time.

Causes

The shoulder joint is made up of tendons, bones, and ligaments enclosed in a connective tissue capsule. In a frozen shoulder, this capsule gradually thickens and tightens, limiting the shoulder’s movement. Even though the exact cause is not fully understood, it is occasionally linked to conditions like diabetes or prolonged immobilization after shoulder surgery or arm fracture.

A frozen shoulder is more likely to occur in women and people above 40 years old.

Diagnosis

Diagnosing a frozen shoulder begins with a review of the medical history and conducting a physical exam. Our clinicians at The Joint Pain Clinic may suggest moving your shoulder in specific ways to assess pain levels and measure the range of motion.

In addition, we can perform an ultrasound scan to examine the frozen shoulder. Other potential causes of shoulder stiffness and pain can also be ruled out with imaging tests like X-rays and MRI.

Treatment Options

We can effectively manage frozen shoulder through a variety of treatments, including:

• Pain-relief medications
• Applying ice packs or heat
• Acupuncture
• Engaging in physical therapy exercises
• Steroid injections
• Joint capsule stretching injections (hydrodilatation)
• Shoulder manipulation under anaesthesia

In cases where these methods fail to provide sufficient relief, your doctor might suggest minimally invasive surgery to eliminate adhesions as well as scar tissue in the shoulder. Nonetheless, such procedures are rarely required.