Frozen Shoulder

What is Frozen Shoulder?

Frozen shoulder, known medically as adhesive capsulitis, is a condition in which the capsule surrounding the shoulder joint thickens, tightens, and becomes inflamed. The result is pain and a steadily shrinking range of movement, especially rotation. It most often affects people aged 40 to 60 and is more common in women.

It typically moves through three phases. The painful freezing phase brings worsening pain, often worse at night. The frozen phase is stiffer than it is painful, with movement severely limited. The thawing phase is a slow return of motion over many months.

Diabetes is a strong risk factor, as are a period of shoulder immobility after surgery or injury, and thyroid disease. Left to run its natural course, the whole cycle can take one to three years.

Symptoms

• A deep ache in the shoulder, often worse at night
• Progressive stiffness that limits everyday reaching
• Marked loss of rotation, such as reaching behind the back
• Pain when lying on the affected side
• Difficulty dressing, washing hair, or fastening a seatbelt
• A sense that the shoulder is locking up

How We Treat It

Our aim is to control pain and shorten the course rather than wait years for it to resolve on its own. In the painful phase, a capsular injection of corticosteroid under image guidance is one of the most effective steps we can take. It calms the inflammation in the capsule and opens a window in which movement becomes possible again. An intra-articular injection places that medication accurately inside the joint where it is needed.

Once pain is under control, restoring movement is the priority. Our physiotherapy team uses manual therapy and a graded stretching programme to recover range of motion, working within the limits the shoulder will tolerate. We progress the programme as the capsule loosens, which is what carries the gains from any injection into lasting function.