Frozen Shoulder (Adhesive Capsulitis)

This consists of the joint capsule thickening and ROM becoming limited and movement of the shoulder joint causing pain. The exact cause of frozen shoulder is unclear but more likely in people with the risk factors below.

Risk Factors

• Diabetes

• Post-surgery

• Arm fracture

• >40 years old and <70 years old

• More common in Women (4x more likely)

• Thyroid conditions

• Parkinson’s

• Cardiovascular conditions

• CRPS

• Cancer

Symptoms

• Sudden onset of unilateral anterior shoulder pain

• Compromise to passive and active ROM

• Self-limiting

• Possible referral of pain to neck

• Clinical diagnosis – rule out other conditions

Treatment

• NSAIDS (Limited research)

• Opioid Analgesics (Severe cases)

• ROM exercises - https://www.nhsaaa.net/allied-health-professionals-ahps/musculoskeletal-service/frozen-shoulder-exercises/[2]

• Steroid Injection (Considered in severe cases)

• Surgical Options in extreme cases

Differential Diagnosis

• Rotator cuff related pain

• Subacromial pathology

• Post-stroke shoulder subluxatio

• Referred pain (Cx spine or malignancy)

• OA

Other

• Full recovery time is 12-36 months.

• Develops in three stages.

• Freezing stage – movement causes pain, ROM becomes more limited (lasts ~2-9 months)

• Frozen stage – Pain may reduce but ROM becomes stiffer and using it beco1.mes difficult. (lasts ~4-12 months)

• Thawing stage – ROM begins to improve. (lasts ~5-24 months)

1. Mezian, K., Coffey, R., and Chang, K. (2022), Frozen Shoulder. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482162/. [Accessed March, 2023.]