Frozen Shoulder (Adhesive Capsulitis): Why the Shoulder Stiffens
Thickening and contraction of the shoulder capsule, progressively restricting movement.
Frozen shoulder occurs when the capsule surrounding the shoulder joint becomes inflamed, thickened and gradually contracts. Its distinguishing feature is that both active movement by the patient and passive movement by an examiner are restricted. It is most often seen between the ages of forty and sixty.
Stages
The condition typically progresses through three stages over many months:
- Freezing: pain predominates, worse at night, and movement gradually decreases
- Frozen: pain eases somewhat but restriction of movement is at its most marked
- Thawing: range of motion is slowly regained
Risk Factors
- Diabetes: the most frequently reported risk factor
- Thyroid disorders
- Prolonged immobility after shoulder or breast surgery
- A period in a sling after an arm fracture
- Female sex and the 40–60 age range
Diagnosis and Treatment
Diagnosis is largely clinical: restriction of both active and passive movement is characteristic. X-rays are usually normal and are requested to exclude other conditions.
Treatment centres on regular stretching and range-of-motion exercises. During painful phases, appropriate pain management and, in selected patients, an intra-articular injection may be added. The process requires patience; with a consistent programme, range of motion is regained progressively. In cases that do not respond over a long period, manipulation under anaesthesia or arthroscopic capsular release may be considered.
If lifting your shoulder has become progressively harder, if you have night pain, and if restriction has increased over weeks, arrange an assessment.
Frequently Asked Questions
Does frozen shoulder resolve on its own?
The condition may improve over a long period, but without treatment some loss of movement can persist. A regular exercise programme helps shorten the course and preserve motion.
Should I rest the arm?
No. Immobility causes the capsule to tighten further. Regular movement and stretching below the pain threshold form the basis of treatment.
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