Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. The cause of adhesive capsulitis is not clear but there have been some links to people with diabetes having an increased risk.

In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. The hallmark sign of this condition is being unable to move your shoulder - either on your own or with the help of someone else. It develops in three stages:

  1. Freezing - In the"freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
  2. Frozen - Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.
  3. Thawing - Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

Frozen Shoulder Treatment

The focus of treatment is to control pain and restore motion and strength through physical therapy. More than 90% of patients improve with relatively simple treatments such as:

Non-steroidal anti-inflammatory medicines - Drugs like aspirin and ibuprofen reduce pain and swelling.
Steroid injections - Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder joint.
Physical therapy - Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before the stretching exercises.

If your symptoms are not relieved by therapy and anti-inflammatory medicines, you and your doctor may discuss surgery. The goal of surgery for frozen shoulder is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anesthesia and shoulder arthroscopy.

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