Frozen Shoulder is an extremely painful condition in which the shoulder is completely or partially unmovable (stiff). Frozen shoulder is also known as adhesive capsulitis. The main symptoms are pain and stiffness, with discomfort being a key feature that can significantly affect daily activities. Frozen shoulder often starts out of the blue, however it can also be triggered by a mild injury to the shoulder. The condition usually goes through three stages: freezing, frozen, and thawing, starting with pain, then stiffness and finally a stage of resolution as the pain eases and most of the movement returns. This process may take a long time, sometimes as long as two or more years.
Frozen shoulder may be associated with diabetes, high cholesterol, heart disease. There is an increased risk of developing frozen shoulder if you have underlying conditions such as diabetes, heart disease, or have had a previous injury or surgery. It may follow surgery or an injury to the shoulder. Frozen shoulder usually affects one shoulder, but in about one in five people, it can affect both.
The lining of the shoulder joint, known as the ‘shoulder capsule’, is normally a very flexible elastic structure. It’s looseness and elasticity allows the huge range of motion that the shoulder has. With a frozen shoulder this capsule (and its ligaments) becomes inflamed, swollen, red and contracted. The exact cause is not fully understood, but it is thought to result from inflammation and scarring (scar tissue) within the shoulder capsule, and changes in the soft tissue structures contribute to the condition. Therefore the normal elasticity is lost and pain and stiffness set in.
Typically frozen shoulder develops slowly, and in three phases:
Freezing phase: Your pain increases with movement and is often worse at night. Shoulder pain continues and there is a progressive loss of motion, making movement increasingly difficult in different directions. This stage typically lasts six to nine months.
Frozen phase: Pain begins to diminish, however, the range of motion is now much more limited in different directions, as much as 50 percent less than in the other arm. This stage may last four to twelve months.
Thawing phase: The condition may begin to resolve. Stiffness subsides and mobility returns as movement is gradually regained. This stage typically lasts for a year, with most patients experiencing a gradual restoration of motion over the next 12 to 42 months.
Diagnosis at a frozen shoulder clinic is based on a combination of your medical history, physical examination, and assessment of frozen shoulder symptoms. During your visit, the specialist will ask about your medical history to help tailor a personalised treatment plan and identify any risk factors.
A physical examination will be performed, which includes testing both the active range and passive range of motion in your shoulder to assess limitations. A key clinical sign of frozen shoulder is an external rotation deficit, where you struggle to rotate your arm outward. Assessments by specialists at a shoulder clinic can differentiate frozen shoulder from other conditions such as a rotator cuff tear, often using imaging like X-rays or MRI scans. HCA UK offers fast access to diagnostic and imaging technology for frozen shoulder diagnosis.
A frozen shoulder can be diagnosed based on clinical signs and symptoms, such as:
Inability to lift your arm above shoulder height
Difficulty reaching out to the side or behind (e.g. reaching for a seat belt)
Inability to throw a ball or perform overhead activities
Trouble quickly reaching for something (e.g. reacting to catch a falling object)
Difficulty reaching behind your back (e.g. fastening a bra or tucking in a shirt)
Pain or discomfort when lying on the affected shoulder, especially at night
While many frozen shoulders improve significantly over 2 to 4 years without treatment, the associated pain and movement limitations often require intervention.
The type of treatment depends on the severity of pain and stiffness, and may include:
At Comfort Health we offer a range of treatments; Physiotherapy, Steroid Injections, Acupuncture and Sports Massage. All of which can help when struggling with a frozen shoulder.
If you feel like you could benefit from a treatment from one of our practitioners Click Here and book in today. Or use the links above to find out more about our services.