Adhesive Capsulitis (Frozen Shoulder)

Some doctors classify frozen shoulder as:

• Primary (idiopathic) frozen shoulder develops on its own, without a clear cause.
• Secondary frozen shoulder develops after another problem, such as an injury, surgery, or a health condition like diabetes.

Based on severity, adhesive capsulitis is classified into three stages: 

• Freezing
• Frozen
• Thawing 

Each stage lasts for 6–9 months and affects pain and stiffness in different ways.

• The primary symptoms of adhesive capsulitis or frozen shoulder are most noticeable as pain and stiffness, especially when trying to rotate the affected shoulder outwards or trying to lift it upwards. 

Certain factors make people more likely to develop frozen shoulder.

• It most often affects 40–60-year-old people.
• Female sex
• It is common in people with diabetes mellitus, hypothyroidism, heart diseases, kidney diseases, or autoimmune conditions.

Doctors use several methods to check for frozen shoulder and to rule out other conditions.

• They assess the range of shoulder motion, both on your own and with support.
• They check the strength of specific shoulder muscles by asking you to lift the arm sideways or forward against their hand.
• An X-ray can rule out other problems, such as calcium deposits or arthritis.
• Magnetic resonance imaging (MRI) can confirm or exclude other shoulder issues.
   

Based on the severity of the condition, one or more of the following treatment approaches may be recommended:

• Non-surgical treatment: Non-surgical treatments aim to relieve pain, improve shoulder movement without surgery. They include:
  • Anti-inflammatory medicines prescribed to reduce pain and swelling.
  • Steroids, taken either orally (by mouth) or given locally as injections, to help with the pain.
  • Ultrasound-guided injection to relieve pain.
  • Hydrodilatation (injecting fluid into the joint to stretch it).
  • Physical therapy to restore movement and strength.
• Surgical treatment: Surgery is rarely needed, but may be required if symptoms remain severe in the frozen stage. Options include:
  • Manipulation under anaesthesia, where the shoulder is gently moved to improve motion.
  • Arthroscopic capsular release, a keyhole surgery, loosens the tight capsule.

Patients are advised to consult their doctor if shoulder pain and stiffness persist after simple measures are taken, if movement becomes restricted, or if pain disturbs their sleep.

While frozen shoulder cannot always be prevented, keeping the shoulder moving and doing gentle stretching exercises after injuries or surgery may reduce the risk.

If you suspect frozen shoulder, you should see an orthopaedic specialist. A physiotherapist may also help with exercises and recovery.