Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited range of motion in the shoulder joint. It typically develops gradually and can take months or even years to resolve, although it often gets better over time with treatment.

What Happens in Frozen Shoulder?

The shoulder joint is surrounded by a capsule of connective tissue. In frozen shoulder, this capsule becomes thickened, inflamed, and tight. As a result, the space within the capsule decreases, and the shoulder becomes stiff and difficult to move. This leads to pain and a restricted range of motion.

Phases of Frozen Shoulder:

Frozen shoulder typically progresses in three stages, each lasting several months:

1. Freezing Stage (Painful Stage):

   • The shoulder becomes increasingly painful, especially with movement.
   • The pain often worsens at night, affecting sleep.
   • The range of motion begins to decrease.
   • This stage can last from 6 weeks to 9 months.

2. Frozen Stage (Adhesive Stage):

   • The pain may decrease, but the shoulder becomes very stiff.
   • The joint’s range of motion is severely limited, and it becomes difficult to perform everyday tasks.
   • This stage can last from 4 to 6 months.

3. Thawing Stage (Recovery Stage):

   • The shoulder gradually begins to regain its mobility.
   • Pain continues to subside, and movement becomes easier.
   • Full recovery can take from 6 months to 2 years.

Causes and Risk Factors:

The exact cause of frozen shoulder is not always clear, but several factors can increase the risk:

• Injury or Surgery: After a shoulder injury or surgery (like rotator cuff surgery), people may avoid moving their shoulder, leading to stiffness.
• Diabetes: People with diabetes are more likely to develop frozen shoulder, though the reason is not well understood.
• Age: It most commonly affects people between the ages of 40 and 60, and it is more common in women.
• Other conditions: Certain conditions like thyroid disorders, heart disease, and Parkinson’s disease may increase the risk.

Symptoms:

• Pain: It can be dull or aching, particularly when moving the shoulder, and more intense at night.
• Stiffness: The shoulder becomes difficult to move in any direction—lifting the arm, reaching overhead, or rotating the arm can be challenging.
• Limited Range of Motion: Over time, the ability to perform simple activities (like combing your hair or reaching for something on a shelf) can become difficult.

Treatment:

Although frozen shoulder can be frustrating, it typically improves with time and treatment. Common approaches include:

• Physical Therapy: Stretching and strengthening exercises can help restore range of motion and prevent further stiffness.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help relieve pain and inflammation.
• Corticosteroid Injections: These injections can reduce inflammation and help relieve pain in the short term.
• Heat and Cold Therapy: Applying heat or cold packs may help ease pain and stiffness.
• Joint Distension: In some cases, a doctor may inject sterile water into the joint to help stretch the capsule and improve movement.
• Surgery: In rare cases, when conservative treatments don’t work, surgery may be considered. This can involve a procedure called manipulation under anesthesia or arthroscopic surgery to remove scar tissue.