Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. Symptoms usually begin gradually, worsen over time and then resolve within one to three years.
The risk of developing frozen shoulder increases if one is recovering from a medical condition or procedure that prevents one from moving the arm such as a stroke, mastectomy or a fracture.
Treatment for frozen shoulder involves motion exercises or medications, such as corticosteroids and numbing medications that are injected into the joint capsule. In rare cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move freely.
Frozen shoulder may recur, but usually in the opposite shoulder. It is unusual for frozen shoulder to recur in the same shoulder.
Frozen shoulder typically develops gradually and in 3 stages. Each stage may last a number of months.
- Freezing stage: any movement of the shoulder causes pain and the shoulder’s range of motion becomes limited.
- Frozen stage: pain may slightly diminish in this stage. However, the shoulder becomes stiffer and using it becomes harder.
- Thawing stage: the range of motion in the shoulder begins to improve. In some cases, pain may worsen at night and disturb sleep.
The bones, ligaments and tendons that make up the shoulder joint are enclosed in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint and at the same time restricts its movement.
The exact cause of frozen shoulder is unclear; however, experts believe that it is associated with conditions such as diabetes or immobilization of the shoulder for a longer period such as after surgery or an arm injury (fracture).
The following factors increase the risk of developing frozen shoulder:
- Age: people 40 and older have an increased risk of frozen shoulder
- Being female
- Prolonged immobility or reduced mobility: such as from a rotator cuff injury, broken arm, stroke, recovery from surgery
- Systemic diseases: diabetes, overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), cardiovascular disease, tuberculosis, Parkinson’s disease
An injury that requires prolonged immobility should be combined with particular exercises that help maintain the range of motion in the shoulder and possibly prevent the development of frozen shoulder.