Understanding Frozen Shoulder: Symptoms, Causes & Treatment

Frozen shoulder, also known as adhesive capsulitis, is a condition where the connective tissue surrounding the shoulder capsule becomes inflamed and thickened. This leads to shoulder pain and stiffness, which gradually limits the range of motion. Thick bands of tissue, called adhesions, develop, and the amount of synovial fluid, which lubricates the shoulder capsule and joint, is reduced.

This condition is characterised by worsening symptoms, and full recovery may take up to 3 years.

In this blog, we will explore the stages, symptoms, causes, treatment options, and risk factors associated with frozen shoulder.

A] Stages of Frozen Shoulder

1. Freezing Stage

This stage involves a gradual increase in shoulder pain, often worsening at night or when resting on the affected side. The pain progresses to stiffness, resulting in limitation of shoulder movements and difficulty performing daily activities.

2. Frozen Stage

In this phase, the pain begins to decrease and is comparatively less than in the freezing stage. However, the shoulder remains stiff, which may cause the muscles to weaken due to reduced movement.

3. Thawing Stage

The thawing stage, also known as the recovery phase, is the final stage when the shoulder movements slowly return to normal and the pain and stiffness gradually improve. However, occasional pain may still occur, especially at night.

B] Symptoms of Frozen Shoulder

• Pain: A dull pain is experienced in the shoulder or the upper arms. It often worsens at night, if lying on the affected side, or with sudden shoulder movement.
• Stiffness: A stiffness that affects one shoulder at a time, resulting in difficulty performing everyday tasks such as dressing, grooming, lifting the arm to reach objects, etc.
• Limited range of motion: You may find it difficult to move your shoulder, especially in certain directions.
• Muscle weakness: Due to reduced use of the shoulder, surrounding muscles can weaken over time, which may compound the stiffness and mobility issues.

If you are experiencing such symptoms and are considering expert consultation to understand the underlying cause, you can explore orthopaedic treatment in Andheri for professional guidance and care.

C] Causes of Frozen Shoulder

• An injury or surgery might be one of the causes that have triggered the development of frozen shoulders.
• Certain medical conditions such as thyroid disorders, cardiovascular diseases may increase the risk of developing frozen shoulders. Diabetics show a strong link with frozen shoulders.
• People with inflammatory conditions such as arthritis or bursitis may experience thickening of the shoulder capsule leading to stiffness and restricted movement.
• People between the ages of 40 and 60 generally develop frozen shoulders, with women being more likely to be affected.

D] Treatment Options for Frozen Shoulder

1. Physical Therapy

Exercise is crucial in improving flexibility, especially in a condition like a frozen shoulder. Performing exercises that stretch the tight shoulder capsule and strengthen the surrounding muscles are effective for recovery.

Regular exercises with a physical therapist can also help regain the range of motion when combined with daily home exercise.

2. Medications

Although medications do not cure frozen shoulders, they are still beneficial in recovery as they enable our participation in physical therapy and daily tasks.  

In the early stages, pain relief and inflammation control are important. Medications such as paracetamol and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, are commonly recommended to treat pain and swelling. In more severe cases, a healthcare provider may prescribe stronger pain relievers and muscle relaxants.

3. Corticosteroid Injections

Corticosteroid injections contain a synthetic version of cortisone, a powerful anti-inflammatory hormone. These injections are usually administered into the joint capsule to reduce pain and inflammation, especially during the early stage of pain.

Corticosteroid injections are effective in providing temporary relief and managing symptoms; however, their use is limited to one or two injections to avoid any potential side effects.

4. Home Care and Activity Modification

To manage the pain at home, heat therapy can be one of the solutions; for example, applying warm compresses or a heating pad to the shoulder, especially before stretching or exercising.

Heat therapy can be followed by cold therapy, in which an ice pack can be applied to reduce pain and inflammation. Performing gentle range of motion exercises, such as the pendulum stretch, which involves leaning forward slightly with your arms hanging down and gently swinging in small circles. However, it is important to ensure that such exercises are only performed if pain is manageable.

Simple activity moderation, such as using the affected arm for light activities, avoiding lifting heavy objects, and using a pillow under or behind the affected arm – all such steps can greatly impact the frozen shoulders.

5. Minimally Invasive Options (Arthroscopic Surgery)

Arthroscopic surgery is a minimally invasive surgery that is recommended when the symptoms do not improve with traditional treatments after 3 to 6 months. This technique involves making small incisions around the shoulder and inserting surgical tools and a tiny medical camera. The camera provides a view of the tight, inflamed joint capsule, and a radiofrequency device is used to precisely cut and release tissue to restore mobility.

One of the key advantages of this approach is less tissue damage. However, physical therapy is crucial after surgery to maintain the motion achieved during the procedure.

In diabetic patients, some degree of shoulder stiffness may persist even after surgery.

The decision on the type of treatment can be made based on the stage and severity of the condition. If you are looking for expert guidance on your issue, consider consulting an orthopaedic doctor in Andheri for personalised guidance.

E] Who Develops Frozen Shoulder?

Frozen shoulder is a more common condition in people aged 40 to 60, especially in women. Individuals with conditions like diabetes or thyroid disorders are normally at a greater risk of developing it.

Although it affects only one shoulder, it generally occurs in the less-used arm, for example, the left shoulder of right-handed individuals.

Conclusion

Frozen shoulder is a painful condition that limits our daily activities and often impacts middle-aged individuals, particularly women. People with underlying health issues like diabetes are also at higher risk. Although many cases improve by managing symptoms through physical therapy, individuals who continue to experience persistent symptoms may benefit from advanced frozen shoulder treatment like arthroscopic surgery. Such minimally invasive procedures can provide effective, long-term relief.

Early diagnosis is crucial for timely recovery and to prevent the condition from worsening.

If you experience persistent stiffness around your shoulder or restricted movement, especially if you are between 40 and 60 years old, consider booking an appointment with Dr. Tanay Prabhoo, a highly trusted orthopaedic surgeon in Mumbai. An expert in joint disorders, Dr. Prabhoo deeply understands these conditions and provides the most accurate solutions to your unique needs.

Dr. Tanay Prabhoo

Inspired by a passion to improve lives through advanced orthopedic care, Dr. Tanay Prabhoo embarked on his medical journey over a decade ago. As a skilled Orthopedic and Spine Surgeon, he has committed himself to treating musculoskeletal and spinal conditions, offering his patients innovative, tailored treatment plans.