Understanding Frozen Shoulder

What is Frozen Shoulder and Why Does it Develop?

Frozen shoulder, medically termed adhesive capsulitis, is a condition that causes stiffness, pain, and limited range of motion in the shoulder joint. This restriction is typically the result of inflammation and thickening of the shoulder capsule, making movement difficult and sometimes very painful. The exact cause of frozen shoulder is not entirely understood but often arises following a period of immobility, such as after an injury or surgery. It is seen more commonly in people over 40, particularly women. Underlying health conditions like diabetes or thyroid disorders can also increase one’s likelihood of developing this painful condition, suggesting a link between systemic health and shoulder mobility.

How Shoulder Anatomy and Everyday Life Contribute to the Condition

The shoulder joint is known for its flexibility and broad range of movement, but this also makes it vulnerable to problems when it's not used regularly. In frozen shoulder, the soft tissues surrounding the joint become inflamed and start to contract or form adhesions, leading to pain and reduced function. Everyday neglect, such as not stretching the shoulder after an injury or stroke, can significantly contribute to the condition. Additionally, poor posture or repetitive overhead motions might not cause frozen shoulder directly but can exacerbate symptoms if the joint becomes immobilised. This underscores the importance of gentle, regular movement and early attention to any discomfort in the shoulder to prevent the cascade of changes that result in adhesive capsulitis.

Symptoms and Diagnosis: Recognising the Early Signs

Frozen shoulder typically progresses through three stages: freezing, frozen, and thawing. Initially, patients notice a gradual onset of dull or aching pain, especially when moving the arm. This pain often worsens at night, disrupting sleep. As the condition advances, stiffness increases, sharply limiting daily activities such as dressing or reaching overhead. Diagnosis is mainly clinical, relying on history and physical examination to assess range of motion and pain triggers. Occasionally, imaging like X-rays or MRI may be recommended to rule out other causes such as arthritis or rotator cuff injuries, but these are rarely necessary for diagnosis. Early recognition of symptoms is crucial for effective management and quicker recovery.

The Psychological and Lifestyle Impact of Frozen Shoulder

Living with frozen shoulder affects more than just physical health; it can impact one’s emotional well-being and quality of life. Persistent pain and restricted movement may limit social interactions, leisure activities, or even basic self-care, leading to frustration, anxiety, or depression in some individuals. The fear of pain during movement often leads people to avoid using the affected arm, which unfortunately worsens stiffness and slows down recovery. This cycle highlights the necessity of a holistic treatment plan that considers both the physical aspects and the psychological burden of frozen shoulder. Support from family, healthcare providers, and gentle encouragement to remain active can make a significant difference in patient outcomes.

Hope and Steps Towards Prevention

While the symptoms of frozen shoulder can be daunting, most individuals ultimately regain significant or even full range of movement with appropriate intervention. Early and gentle mobilisation of the shoulder, even after injuries or surgeries, is key in preventing the condition. Those at higher risk—such as people with diabetes or a history of prolonged shoulder immobilisation—should be especially vigilant about keeping their shoulders active and seeking early medical advice if pain or stiffness develops. Incorporating simple shoulder stretches, maintaining overall health, and being mindful of posture at work or during daily routines are practical strategies for prevention. Early intervention remains the best defence against prolonged discomfort and disability from frozen shoulder.

adhesive capsulitis
shoulder pain
restricted movement
shoulder joint
stiffness
limited range of motion

FAQs About Frozen Shoulder and Its Development

What is the main cause of frozen shoulder?

The main cause is often unclear but is thought to stem from inflammation and thickening of the shoulder capsule after a period of immobility. For some, it follows an injury, surgery, or a health condition that limits shoulder movement.

How can I tell if I have frozen shoulder and not another shoulder problem?

Frozen shoulder is characterised by progressive pain and a marked, gradual reduction in shoulder mobility, usually without a specific injury. Diagnosis is confirmed by a physical exam assessing both active and passive range of motion.

Is frozen shoulder permanent?

No, frozen shoulder is not usually permanent. Most cases improve over time, especially with early intervention and physical therapy. However, recovery can take several months to years.

Can frozen shoulder be prevented?

Yes, in many cases. Gentle movement and regular stretching after injury or surgery can reduce the risk. Those prone to adhesive capsulitis—such as people with diabetes—should be particularly proactive in maintaining shoulder mobility.

Are there activities I should avoid if I have frozen shoulder?

It is wise to avoid strenuous activities that increase pain, but gentle, pain-free range-of-motion exercises are encouraged. Prolonged rest or avoidance of movement can actually worsen the condition.

When should I see a doctor about shoulder pain?

If you experience persistent pain, especially with increasing stiffness and limitation of shoulder movement, it’s important to consult a healthcare professional early. Early diagnosis improves recovery outcomes and reduces the need for invasive treatments.

References

Lewis J. Frozen shoulder – what, why and when? Shoulder & Elbow (2011).
Hanchard N.C.A., Goodchild L., Thompson J., et al. Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder. Physiotherapy (2012).