Frozen shoulder
What is Frozen shoulder?
Frozen shoulder, or adhesive capsulitis, is a condition where the shoulder capsule becomes inflamed, thickened and tight. It causes pain and marked restriction of movement, especially external rotation. It can occur without a clear trigger or after injury, surgery or periods of shoulder immobilisation.
Common symptoms
The condition often begins with increasing pain, particularly at night, followed by progressive stiffness. Patients may struggle to reach behind the back, put on a jacket, fasten a seatbelt, wash hair or sleep comfortably on the affected side.
Diagnosis and imaging
Frozen shoulder is mainly a clinical diagnosis based on a characteristic pattern of global stiffness. X-rays are important to exclude shoulder osteoarthritis or other bony causes of stiffness. Ultrasound or MRI may be used when rotator cuff pathology, inflammatory disease or another diagnosis is suspected.
Non-surgical treatment
Treatment aims to control pain and preserve function while the condition evolves. Options include education, gentle physiotherapy, anti-inflammatory medication, corticosteroid injection and hydrodilatation in selected patients. Aggressive stretching during the painful phase can aggravate symptoms.
Surgical treatment
Surgery is considered for severe, persistent stiffness that does not improve with time and non-surgical treatment. Options include manipulation under anaesthesia and arthroscopic capsular release, with the choice guided by severity, duration and patient goals.
Recovery and follow-up
Frozen shoulder often improves slowly. After injection or hydrodilatation, therapy focuses on comfortable motion. After capsular release, early supervised physiotherapy is essential to maintain the movement gained during surgery.
Frozen shoulder FAQs
How long does frozen shoulder last?
It can last many months and sometimes longer than a year. The course varies, but treatment can reduce pain, improve function and shorten the period of severe limitation for many patients.
How is frozen shoulder diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
Is frozen shoulder the same as arthritis?
No. Frozen shoulder is mainly a capsular stiffness problem, while arthritis is wear of the joint surfaces. X-rays help distinguish the two because the treatment pathway is different.
Will I need surgery for frozen shoulder?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
Should I force the shoulder through pain?
No. A measured program is usually better. Overly aggressive stretching can increase inflammation, especially in the painful phase.
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