Frozen shoulder, also known as adhesive capsulitis, is a painful and disabling condition affecting the shoulder joint. It leads to stiffness, limited range of motion, and discomfort that can interfere with daily activities. This condition most commonly affects people between the ages of 40 and 60 and is more prevalent in women than men.
In this article, we’ll explore the causes, signs and symptoms, treatment options, and effective physiotherapy management strategies for frozen shoulder.
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✅ What Is Frozen Shoulder?
Frozen shoulder occurs when the connective tissue surrounding the shoulder joint (the capsule) becomes inflamed and thickened. This restricts movement and leads to pain and stiffness over time. The condition typically develops gradually and progresses through three stages.
🔍 Stages of Frozen Shoulder
1. Freezing Stage (Painful Phase)
- Persistent pain in the shoulder, especially at night
- Gradual loss of movement
- Lasts between 6 weeks to 9 months
2. Frozen Stage (Stiffness Phase)
- Pain may reduce but stiffness worsens
- Significant limitation in shoulder movement
- Difficulty with daily tasks like dressing or reaching overhead
- Duration: 4 to 6 months
3. Thawing Stage (Recovery Phase)
- Pain continues to subside
- Movement gradually improves
- Recovery may take 6 months to 2 years
⚠️ Causes and Risk Factors
The exact cause of frozen shoulder isn’t always known, but several factors can increase the risk:
- Shoulder immobility due to injury, surgery, or prolonged inactivity
- Diabetes (both type 1 and type 2)
- Thyroid disorders (hypothyroidism or hyperthyroidism)
- Cardiovascular diseases
- Stroke or neurological conditions
🩺 Symptoms of Frozen Shoulder
Common signs and symptoms include:
- Dull or aching shoulder pain
- Limited ability to move the arm or shoulder
- Muscle weakness
- Pain that worsens at night or with movement
These symptoms tend to worsen over time if left untreated.
🧪 Diagnosis of Frozen Shoulder
A healthcare provider will typically diagnose frozen shoulder based on:
- Medical history and symptom review
- Physical examination to assess range of motion
- Imaging tests (X-ray, MRI, or ultrasound) to rule out other issues like arthritis or rotator cuff tears
💊 Treatment Options for Frozen Shoulder
Treatment aims to relieve pain and restore shoulder mobility. Most cases can be managed without surgery.
Non-Surgical Treatments:
- Anti-inflammatory medications (e.g., NSAIDs)
- Corticosteroid injections to reduce inflammation
- Heat or ice therapy for pain relief
Surgical Options (for severe or resistant cases):
- Manipulation Under Anesthesia (MUA) – the shoulder is gently moved while the patient is under anesthesia to break up scar tissue
- Arthroscopic Capsular Release – a minimally invasive procedure to cut and release the tight shoulder capsule
🏋️♀️ Physiotherapy for Frozen Shoulder
Physiotherapy plays a critical role in managing frozen shoulder at every stage. A personalized exercise program can help reduce pain, improve movement, and accelerate recovery.
Physiotherapy Goals:
- Control pain and inflammation
- Maintain and improve joint mobility
- Restore muscle strength and function
Stage-Specific Physiotherapy:
🔹 Freezing Stage:
- Gentle pendulum exercises
- Pain management techniques (ice, heat, TENS)
- Avoid aggressive stretching to prevent worsening pain
🔹 Frozen Stage:
- Active and passive range of motion exercises
- Stretching and joint mobilizations
- Begin isometric strengthening as tolerated
🔹 Thawing Stage:
- Increase intensity of stretches and mobility drills
- Strength training for rotator cuff and scapular muscles
- Functional training to restore normal activities
Recommended Exercises:
- Wall climbing (finger walk)
- Towel stretches
- Cross-body arm stretch
- External/internal rotation using a stick or band
Working with a licensed physiotherapist ensures exercises are done safely and effectively.
📈 Recovery and Prognosis
Frozen shoulder typically resolves over time, but full recovery can take anywhere from 1 to 3 years. Early diagnosis, consistent physiotherapy, and adherence to treatment significantly improve outcomes.
📝 Final Thoughts
Frozen shoulder is a challenging yet treatable condition. Recognizing early symptoms, getting a proper diagnosis, and starting physiotherapy-based treatment are key to a successful recovery. With the right approach, most individuals regain full shoulder function and return to their normal activities.
🔑 Frequently Asked Questions (FAQs)
❓ How long does frozen shoulder last?
It can last from several months up to 2–3 years, depending on the severity and treatment.
❓ Can frozen shoulder heal on its own?
Yes, but recovery is faster and more effective with physiotherapy.
❓ Is frozen shoulder linked to diabetes?
Yes, individuals with diabetes are more likely to develop frozen shoulder.