Frozen shoulder: Understanding causes, symptoms, and treatment

Written in association with: Mr Socrates Kalogrianitis
Published: | Updated: 28/10/2024
Edited by: Conor Lynch

Frozen shoulder, also known as adhesive capsulitis, is a painful condition that causes stiffness and limited movement in the shoulder joint. It develops when the connective tissue surrounding the shoulder, known as the capsule, becomes inflamed and tightens, restricting motion. This condition can last for months or even years, significantly impacting daily activities and overall quality of life.

Causes and risk factors

The exact cause of frozen shoulder is not fully understood, but it is often associated with prolonged immobilization of the shoulder due to injury, surgery, or a medical condition such as a stroke. People with certain health issues, such as diabetes, heart disease, thyroid disorders, or Parkinson’s disease, are at higher risk of developing frozen shoulder. Additionally, women between the ages of 40 and 60 are more commonly affected than men.

 

Stages and symptoms

Frozen shoulder typically develops in three stages, each with distinct symptoms:

 

  1. Freezing stage: This is the initial stage, where pain gradually worsens, and the range of motion in the shoulder begins to decrease. This stage can last for six weeks to nine months.

  2. Frozen stage: During this phase, the pain may diminish, but the stiffness in the shoulder persists. The range of motion is severely restricted, making it difficult to perform daily tasks. This stage can last four to six months.

  3. Thawing stage: In the final stage, the shoulder begins to regain movement, and stiffness gradually improves. This stage can take six months to two years.

 

Treatment options

Treatment for frozen shoulder typically focuses on pain management and restoring shoulder mobility. Physical therapy is a cornerstone of treatment, with exercises designed to improve range of motion and strengthen the surrounding muscles. Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, or oral steroids may be prescribed to reduce inflammation and pain.

 

In more severe cases, manipulation under anesthesia or shoulder arthroscopy may be recommended. These procedures aim to stretch or release the tight shoulder capsule, allowing for greater mobility.

 

Frozen shoulder can be frustrating due to its long recovery time, but with early diagnosis and a structured treatment plan, most people regain full function of their shoulder.

By Mr Socrates Kalogrianitis
Orthopaedic surgery

Mr Socrates Kalogrianitis is a distinguished consultant orthopaedic surgeon with expertise in diagnosing and treating complex shoulder and elbow conditions through surgical intervention. He currently practises at The Harborne Hospital.

He is highly regarded for his use of minimally invasive, cutting-edge arthroscopic techniques that significantly enhance recovery for patients dealing with issues such as shoulder instability, rotator cuff injuries, frozen shoulder, as well as arthritis and stiffness in the shoulder and elbow. His particular area of interest lies in advanced arthroscopic procedures, including rotator cuff repair, tendon transfers, shoulder stabilisation surgeries like the arthroscopic Bankart Repair and the arthroscopic Latarjet procedure, which are designed to address various shoulder pathologies effectively.

Mr Kalogrianitis serves as a consultant at University Hospitals Birmingham NHS Foundation Trust, where he specialises in shoulder surgery. In addition to his NHS role, he practices privately at the Priory Hospital in Birmingham, as well as the Spire Little Aston Hospital in Sutton Coldfield. He collaborates closely with physiotherapy teams to ensure seamless rehabilitation and optimal outcomes for his patients. His commitment to the field extends beyond clinical practice; he is actively involved in research, contributing

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