Frozen shoulder, also known as adhesive capsulitis, is a condition
affecting the joint capsule of the shoulder. It is characterized by
inflammation of the capsule, leading to pain and stiffness with shoulder movements.
Frozen shoulder is
categorized as either primary or secondary. Primary frozen shoulder occurs for
no clear reason, while secondary frozen shoulder develops following an injury
or surgery of the joint.
Frozen shoulder usually
follows a typical pattern and can be separated into three stages, freezing,
frozen and thawing. The pain begins in the freezing stage as an ache or twinge
with movements. The pain gradually increases, and the shoulder begins to feel
stiff as well as painful. Usually, shoulder movements away from the body or
rotating outwards are the most painful and restricted.
As the condition
progresses, everyday activities can be significantly impacted, with activities
such as dressing, grooming, reaching overhead and behind the back becoming
difficult. Lifting heavy objects can be very painful, and the pain is often
felt at night-time, interrupting sleep. The three stages follow a typical
Freezing – Pain is present at rest/night, increasing pain and stiffness
with shoulder abduction and external rotation.
Frozen– Pain starts to lessen, but the stiffness of the shoulder joint
Thawing – Pain reduces to lower levels and movement begins to return.
Frozen shoulder will
usually resolve on its own without any long-lasting stiffness. However,
complete recovery does not always occur.
Frozen shoulder usually
affects people over the age of 40 and women are affected more often than men.
While no definite cause has been identified, there are some factors that increase
the risk of developing a frozen shoulder. These include diabetes, prolonged
immobilization, trauma, stroke, thyroid dysfunction, heart disease and
The early stages of frozen
shoulder can mimic other shoulder conditions, and these should first be ruled
out by a thorough examination. While frozen shoulder is a self-limiting
condition, meaning it will resolve on its own without treatment, this can take
up to 2-3 years. Physiotherapy during this time focuses on reducing pain as
much as possible and helping patients to cope and adapt to their symptoms
during the freezing and frozen stages.
As the condition moves
into the thawing stage, physiotherapy aims to help restore strength, movement
and control to the shoulder. The entire process can be extremely distressing
for patients and providing support and education as they move through the
stages of the condition is an essential part of treatment.
If you have any concerns about shoulder pain that is not
resolving, come and have a chat with one of our physiotherapists to see how we
might be able to help you. None of
the information in this newsletter is a replacement for proper medical advice.
Always see a medical professional for advice on your injury.