A frozen shoulder (sometimes referred to as shoulder capsulitis) describes a condition in which the soft tissue which encapsulates the joint (joint capsule) becomes painful and inflamed. The process leads to a thickening of the local tissue, which causes the movements of the shoulder to become increasingly stiff (frozen). Fortunately, in most cases, frozen shoulder resolves over 2-3 years.
Frozen shoulder can occur after trauma to the shoulder, but more commonly occurs gradually with no injury or reason. Some people are at greater risk of developing a frozen shoulder:
- Female gender
- Age range 40-60
- Diabetic individuals
Typically, a frozen shoulder has 3 phases:
Stage 1 ('Freezing' phase) - Typically 6-9 months
Inflammation to the joint capsule develops and progresses. The active inflammation often means that the pain is constant rather than movement related and pain levels can be severe and worse through the night. Stiffness to the shoulder movements gradually increases throughout this phase.
Stage 2 ('Frozen' phase) - Typically 4-12 months
Inflammation levels reduce and as such, pain levels become less severe, less constant, and more related to movement. Stiffness to the shoulder movement remains.
Stage 3 ('Thawing' phase) - Typically 12-24
As the tissue within the joint capsule gradually normalises, shoulder flexibility gradually improves as does the pain on shoulder movements. To maximise improvement, it is important to work on exercising the shoulder to regain range of movement and strength during this phase.
A frozen shoulder can be reliably diagnosed by your clinician discussing your symptoms and by conducting a physical examination.
The main feature on examination is increasing restriction of movement at the shoulder. This gradually progresses to involve all movements over a few months (The freezing phase)
X-rays and scans are not routinely required, unless you are considering a form of intervention.