What is frozen shoulder?
Frozen shoulder is a condition that causes pain and stiffness in the shoulder joint. It occurs when the capsule surrounding the shoulder joint becomes inflamed and tight, restricting movement. The condition typically develops gradually and can take months or even years to fully resolve.
Who is affected?
- Most common in people aged 40 to 60
- More frequent in women
- Higher risk in people with diabetes, thyroid disorders, after shoulder injury or following surgery
Diagnosis
Your clinician may diagnose Frozen Shoulder based on:
- Talking about your Your symptoms and and medical history, with a thorough & physical examination – this is the most common way to diagnose this condition.
This is done with a combination of movement tests and nerve tests to assess how well the nervous system is functioning.
- X-rays can be useful to exclude a problem with the shoulder joint, as Frozen Shoulder and Osteoarthritis can mimic one another.
Phases of frozen shoulder
Frozen shoulder typically progresses through three overlapping stages:
- Painful Phase (Painful Phase)
- Gradual onset of pain
- Increasing pain and stiffness
- Pain often worse at night
- Lasts 2 to 12 months
- Stiff Phase (Stiffness Phase)
- Pain may reduce
- Shoulder becomes very stiff
- Daily activities become difficult
- Lasts 4 to 12 months
- Recovery Phase
- Improving stiffness
- Very little pain
- Lasts 4 to 12 months
Symptoms
- Dull or aching pain in the shoulder or outer aspect of the upper arm
- Pain that worsens with movement or at night
- Stiffness that affects daily tasks
Self-care and management
1. Pain Relief
- Use paracetamol or ibuprofen as needed
- Heat packs may help relax muscles in later stages
2. Activity Modification
- Avoid painful overhead movements
- Maintain gentle use of the shoulder to prevent further stiffness
3. Exercises
Gentle stretching and mobility exercises can help. Do exercises daily within your comfort zone, as it is important to maintain as much flexibility as you can.
4. MSK Rehabilitation
- May be recommended if symptoms persist
- Focuses on reducing stiffness
5. Injections
- Steroid injections may reduce inflammation and pain. These tend to be most beneficial in the ‘Painful Phase’, but are not a required if you’re able to tolerate your symptoms and continue to function/sleep normally.
- Hydrodilatation (fluid injection into the joint) may be considered in some cases and may be offered under ultrasound guidance. This is a relatively infrequent treatment and the majority of people will not need to consider this.
When to seek medical advice
- Pain is severe or worsening – consider contacting your GP
- You cannot perform daily activities
- Symptoms persist beyond a few months – consider contacting your GP or self-referring to the MSK service.
Outlook
- Most people recover fully, though it may take 1 to 3 years
- Metabolic conditions, such as Diabetes may mean recovery is slower.