Man holding shoulder in pain

Frozen Shoulder – Causes & Diagnosis

Of all the joints in the human body, the shoulder joint is the most mobile. To facilitate the full range of movements made by your shoulder, it is supported by a network of muscles, tendons and ligaments.

Frozen shoulder (adhesive capsulitis) is a condition caused by the capsule of connective tissue that surrounds the shoulder joint becoming inflamed and thickened. This restricts the shoulder’s movement, causing pain, stiffness and loss of mobility.

We are experts in the diagnosis and treatment of frozen shoulder and this blog covers who is most likely to be affected, the symptoms to look out for, how the condition is diagnosed and what treatments are available.

What is frozen shoulder?

A frozen shoulder is a painful condition that eventually prevents you from moving your shoulder properly and causes stiffness and immobility in the joint. The pain may be worse at night which can make it difficult to sleep.

Who is at risk of frozen shoulder?

Experts are unsure precisely what causes frozen shoulder although it is particularly common in people with diabetes. It occurs more often in women than men and in people who have had prolonged immobility of the shoulder due to injuries, fractures or recovery from surgery. Anything that prevents you from moving your arm, including stroke or mastectomy, may increase the likelihood of frozen shoulder and certain diseases also increase your risk, including diabetes, cardiovascular disease and thyroid conditions. The condition does not often develop in people over the age of 60.

What are the symptoms of frozen shoulder?

Frozen shoulder causes worsening pain and immobility in the shoulder. There are three phases which can last up to two years in total:

  • Freezing (painful) stage: In the early stages pain at rest and with most movements is predominant, the amount of movement possible becomes less and less.
  • Frozen (stiff) stage: In this stage the pain may start to ease but your shoulder will become extremely stiff and more difficult to use.
  • Thawing (recovery) stage: In the latter stages, the range of movement in your shoulder will slowly start to improve.

How is frozen shoulder diagnosed?

When we see a patient with a suspected frozen shoulder we will carry out a physical examination and ask about symptoms. It is essential to have an X-ray to rule out a degenerative condition like arthritis.

What are the treatments for frozen shoulder?

In many cases a frozen shoulder will resolve by itself over a prolonged period of time. You can take pain killers and anti-inflammatories to relieve pain or your doctor may be able to prescribe a stronger painkiller if the discomfort is severe. Doing shoulder exercises recommended by a physiotherapist can help to improve the range of motion in your shoulder and speed up your recovery.

If the symptoms persist or become severe there are several possible treatment options:

  • Injections of steroids and local anaesthetic can provide a short-term relief in the freezing stage. In some cases, we use ultrasound to help to guide the position of the needle more accurately. It normally takes a few days for the injection to take effect and the benefits can last for several months.
  • Keyhole surgery (arthroscopy) may be used if the shoulder has become very tight and stiff, or has failed to respond to other treatments.

If you have developed a frozen shoulder, talk to us about getting an accurate diagnosis and the most effective treatment options to help you recover full use of your shoulder joint.

Orthopaedic Consultant & Surgeon | London

Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).

Telephone: 020 376 15987


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