What is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, is a condition where the shoulder joint has a loss of motion, i.e., “frozen”. The pattern of pain and restriction in movement is fairly characteristic. 

This condition can last from weeks to months.  

A classical frozen shoulder follows the following stages: 

• Freezing — starts with a significant amount of pain but has an acceptable amount of shoulder movement
• Frozen — develops more stiffness and restriction in movement, but pain reduces
• Thawing — gradual return of movement

What are the Common Frozen Shoulder Causes?

Frozen shoulder can be classified into two categories:

• Primary frozen shoulder
• The primary cause of frozen shoulder is unknown. Today, no comprehensive etiological model exists! However, research has shown people with diabetes are more prone to develop frozen shoulder
• Secondary frozen shoulder
• Clear evidence of trauma and usually involves structural changes within or adjacent to the joint, such as fractures and tendon injuries

By and large, however, frozen shoulder can occur without any known cause.

What Are the Signs and Symptoms of Frozen Shoulder?

These are possible signs of frozen shoulder:

• Loss of normal ability to move in all directions, especially with lifting your arm, reaching behind your back and/or behind your head
• Painful movement of the shoulder
• “Grinding” when moving your shoulder

What Are the Risk Factors of Frozen Shoulder?

• Traumatic shoulder injury
• Prolonged immobility of the shoulder
• Post-surgery (especially after shoulder reconstruction or mastectomy)
• Diabetes

What are the Frozen Shoulder Treatments Available?

1. Medication

Anti-inflammatory medication may be prescribed during the initial stage.

2. Physiotherapy

The goals of physiotherapy include: 

• Reduce pain using modalities such as ice, heat or interferential current therapy
• Improve range of movement through mobilisation, exercises and eventually regain functional movement
• Improve muscle strength and control

3. Surgical

For patients who do not respond to conservative treatment, the doctor might suggest surgery such as manipulation under anaesthesia to help to increase the range of movement. For further information, please discuss this with your orthopaedic doctor.

Prognosis for Frozen Shoulder

If left alone, it may take up to two years to resolve some complications of the frozen shoulder, such as weakness and reduction in range of movement. Factors affecting recovery include the severity of the frozen shoulder and compliance with an exercise programme.

How can I Prevent Frozen Shoulder?

Unfortunately, you cannot prevent frozen shoulder from happening — but you may minimise the complications by doing the exercises taught regularly. The condition is such that you will have recurrences of stiffness and twinges of pain from time to time. Continue your exercises during these periods only as pain allows.

What Can I Do to Help Myself?

It is important to do your shoulder rehabilitation exercises as prescribed by your physiotherapist. Please consult your healthcare provider before you start any form of self-exercise and treatment. Engaging in the exercises diligently can help with the treatment of the injury.

When can I Return to my Sport or Physical Activity?

Everyone recovers from an injury at a different rate. In general, you should be able to trial a return to normal or vigorous activity when: 

• Your injured shoulder has an almost full range of movement without pain
• Your injured shoulder has regained normal strength compared to the uninjured shoulder

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