Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited mobility in the shoulder joint. It is one of the most disabling shoulder problems and can make simple tasks—like combing your hair, reaching for something on a shelf, or even wearing clothes—extremely difficult.
This condition generally affects individuals between the ages of 40 to 60 years and is more common in women compared to men. People with certain underlying health conditions, such as diabetes, thyroid disorders, heart disease, or previous shoulder injuries, are more likely to develop frozen shoulder.
If not treated properly and on time, frozen shoulder can last for years and significantly impact quality of life. However, with early diagnosis, proper therapy, and the right treatment approach, patients can regain normal shoulder function and return to daily activities.
What Exactly Happens in Frozen Shoulder?
In a healthy shoulder joint, the bones, tendons, and ligaments are surrounded by a flexible capsule filled with synovial fluid, which allows smooth and painless movement.
In frozen shoulder, this capsule thickens and tightens, forming adhesions (scar tissue). This reduces the space inside the joint, making the shoulder stiff and painful. Over time, the shoulder “freezes,” making it very difficult to move, even with external help.
Risk Factors of Frozen Shoulder
While frozen shoulder can develop in anyone, certain risk factors make it more likely:
- Age and Gender: Common between 40–60 years, with women at higher risk.
- Diabetes: Nearly 20–30% of people with diabetes experience frozen shoulder at some point.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can increase risk.
- Previous Shoulder Injury or Surgery: Immobilization after fractures or rotator cuff injuries often leads to stiffness.
- Other Health Conditions: Heart disease, Parkinson’s disease, and prolonged immobility due to illness can contribute.
Stages of Frozen Shoulder
Frozen shoulder develops gradually and is typically divided into three stages, each with different symptoms:
- Freezing Stage (Painful Stage)
- Duration: 6 weeks to 9 months
- Symptoms: Persistent, worsening shoulder pain that worsens at night. Movements become increasingly restricted.
- Frozen Stage (Stiffness Stage)
- Duration: 4 to 12 months
- Symptoms: Pain may reduce slightly, but stiffness becomes severe. Activities such as reaching overhead or behind the back are very difficult.
- Thawing Stage (Recovery Stage)
- Duration: 6 months to 2 years
- Symptoms: Gradual improvement in shoulder mobility. Full recovery is possible, though it may take a long time.
Symptoms of Frozen Shoulder
The symptoms can vary depending on the stage but generally include:
- Dull or aching pain in the outer shoulder or upper arm
- Increased pain at night, disturbing sleep
- Difficulty in daily activities, such as lifting the arm, dressing, or reaching overhead
- Gradual loss of shoulder motion—first external rotation, then elevation, and finally internal rotation
Diagnosis of Frozen Shoulder
A doctor or orthopedic specialist typically diagnoses frozen shoulder through:
- Medical History: Evaluating pain patterns, duration, and associated conditions.
- Physical Examination: Checking range of motion in different directions.
- Imaging Tests: X-rays, MRI, or ultrasound may be done to rule out arthritis, rotator cuff tears, or other conditions.
Treatment Options for Frozen Shoulder
The good news is that frozen shoulder can usually be treated without surgery. Treatment focuses on reducing pain and improving mobility.
1. Medications
- Anti-inflammatory drugs (NSAIDs) such as ibuprofen help relieve pain and swelling.
- Pain relievers may be prescribed to manage severe discomfort.
2. Physical Therapy
- This is the cornerstone of treatment.
- Stretching exercises, range-of-motion movements, and strengthening routines gradually restore flexibility.
- Consistency is key—regular physiotherapy sessions improve long-term outcomes.
3. Steroid Injections
- Corticosteroid injections into the shoulder joint reduce inflammation and provide pain relief.
- These are most effective in the early stages.
4. Hydro-dilatation
- In this minimally invasive procedure, sterile fluid is injected into the shoulder joint to stretch the capsule and improve mobility.
5. Surgery
- Reserved for severe cases where conservative treatments fail.
- Options include:
- Arthroscopic Capsular Release – Cutting through tight portions of the joint capsule using a small camera.
- Manipulation Under Anesthesia (MUA) – The surgeon moves the shoulder forcefully while the patient is under anesthesia to break adhesions.
Self-Care and Home Remedies
Along with medical treatment, home-based strategies can accelerate recovery:
- Heat Therapy: Applying warm compresses helps relax stiff muscles before exercises.
- Cold Therapy: Reduces inflammation and eases sharp pain after activity.
- Gentle Stretching: Simple movements like pendulum swings, towel stretches, and wall climbing exercises improve flexibility.
- Maintain an Active Lifestyle: Avoid complete immobility; gentle movement prevents worsening stiffness.
Recovery Timeline
Frozen shoulder is often described as a self-limiting condition, meaning it eventually improves on its own. However, without treatment, recovery can take up to 3 years.
With proper medical care and physical therapy, most patients recover much faster—typically within 12–18 months.
Can Frozen Shoulder Be Prevented?
While not always preventable, the following steps reduce risk:
- Perform gentle shoulder stretches daily, especially after surgery or injury.
- Manage underlying conditions like diabetes and thyroid disorders.
- Avoid prolonged immobilization—use prescribed exercises after fractures or surgeries.
- Maintain good posture and shoulder strength through regular exercise.
When to See a Doctor
You should seek medical advice if:
- Shoulder pain persists for more than a few weeks
- Pain is severe and worsens at night
- You notice a progressive loss of mobility
- Daily activities like dressing, combing hair, or reaching for objects become very difficult
Key Takeaway
Frozen shoulder may be painful and long-lasting, but it is treatable and manageable. Early recognition of symptoms, timely diagnosis, and consistent treatment with physiotherapy, medications, and in some cases, injections or surgery can restore shoulder function.
The most important thing is not to ignore the early signs. With dedication to therapy and proper medical guidance, patients can regain mobility, reduce pain, and return to normal life.
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