Frozen Shoulder

Frozen Shoulder, medically known as Adhesive Capsulitis, is a painful and disabling condition that causes progressive stiffness and restriction of movement in the shoulder joint. It develops when the capsule surrounding the shoulder joint becomes thickened, tight, and inflamed, significantly limiting mobility.

Frozen shoulder most commonly affects women between the ages of 40 and 60 and is more frequently seen in individuals with diabetes or following prolonged shoulder immobility after injury or surgery.

Frozen Shoulder

What Causes Frozen Shoulder?

Frozen shoulder occurs due to inflammation and tightening of the shoulder capsule. Risk factors include:

  • Diabetes

  • Thyroid disorders

  • Previous shoulder injury or surgery

  • Prolonged immobilisation

  • Post-viral or inflammatory conditions

Stages of Frozen Shoulder

1. Freezing Stage

Gradual onset of pain that worsens over time. Shoulder movement becomes increasingly restricted.

2. Frozen Stage

Pain may slightly improve, but stiffness becomes severe, significantly limiting daily activities such as dressing or reaching overhead.

3. Thawing Stage

Gradual improvement in movement and reduction in stiffness over months.

Common Symptoms

  • Persistent shoulder pain (often worse at night)

  • Severe restriction in range of motion

  • Difficulty lifting the arm or reaching behind the back

  • Stiffness affecting daily tasks like dressing or driving

Diagnostic Assessment

  • Detailed clinical examination

  • Diagnostic ultrasound scan to assess the joint and rule out rotator cuff tears

  • Imaging (if required) to confirm diagnosis

Early and accurate diagnosis is essential to prevent long-term stiffness.

Treatment Options for Frozen Shoulder

Conservative Management

  • Pain relief medication (if appropriate)

  • Gentle, guided stretching exercises

  • Activity modification

Physiotherapy & Rehabilitation

  • Structured mobility programs

  • Passive and active stretching techniques

  • Strengthening exercises as mobility improves

  • Home exercise guidance to prevent recurrence

Injection Therapy

  • Ultrasound-guided corticosteroid injection to reduce inflammation and pain

  • Hydro-dilatation (hydrodistension) to stretch and expand the tightened capsule

Advanced Treatment

  • Manipulation under anaesthesia in selected resistant cases

  • Surgery (rarely required) if conservative treatment fails

Why Early Treatment Matters

Frozen shoulder can last from several months to over two years if untreated. Early intervention helps reduce pain, speed up recovery, and prevent prolonged stiffness.

If you are experiencing persistent shoulder pain and reduced movement, it is important to consult a qualified healthcare professional for an accurate diagnosis and appropriate treatment plan.