Frozen shoulder

Overview

Frozen shoulder (adhesive capsulitis) is a condition in which the shoulder joint becomes painful, stiff, and difficult to move due to thickening and tightening of the joint capsule. The condition usually develops gradually and progresses through stages of increasing pain followed by marked restriction of shoulder movement. Everyday activities such as reaching overhead, dressing, combing hair, or lifting objects can become difficult.


Early diagnosis and timely frozen shoulder treatment help reduce pain, improve mobility, and shorten recovery time. Most patients respond well to non-surgical treatment, while persistent cases may require minimally invasive procedures or surgery.


At Sarvodaya Hospital, our experienced orthopaedic surgeons, shoulder specialists, sports medicine experts, and physiotherapists provide comprehensive shoulder stiffness treatment using advanced imaging, personalised rehabilitation programmes, and minimally invasive treatment options.

Symptoms of Frozen Shoulder

• Persistent shoulder pain
• Shoulder stiffness
• Limited shoulder movement
• Difficulty raising the arm
• Pain during overhead activities
• Difficulty dressing or combing hair
• Night-time shoulder pain
• Reduced shoulder flexibility
• Difficulty performing daily activities

Causes of Frozen Shoulder

• Shoulder injury
• Shoulder surgery
• Prolonged shoulder immobilisation
• Diabetes
• Thyroid disorders
• Rotator cuff disorders
• Stroke
• Parkinson's disease
• Unknown inflammatory changes

Risk Factors for Frozen Shoulder

Certain medical conditions and lifestyle factors increase the likelihood of developing frozen shoulders.

• Diabetes: People with diabetes have a significantly higher risk of developing adhesive capsulitis.
• Prolonged Shoulder Immobilisation: Keeping the shoulder immobile after injury or surgery increases the risk of joint stiffness.
• Age Between 40 and 60 Years: Frozen shoulder occurs most commonly in middle-aged adults.
• Thyroid Disorders: Both hypothyroidism and hyperthyroidism are associated with an increased risk of frozen shoulder.

Diagnosis of Frozen Shoulder

Early diagnosis helps confirm the condition and exclude other causes of shoulder pain.

• Clinical Examination: Doctors assess shoulder pain, range of movement, joint stiffness, and functional limitations.
• Medical History: A detailed history identifies previous injuries, surgery, diabetes, or prolonged shoulder immobilisation.
• X-rays: X-rays help exclude arthritis, fractures, or other bone abnormalities affecting the shoulder.
• MRI Scan: MRI evaluates soft tissues, rotator cuff injuries, and confirms associated shoulder conditions.
• Ultrasound: Musculoskeletal ultrasound assesses tendons, ligaments, and surrounding shoulder structures.

Treatment Options & Technology for Frozen Shoulder

Frozen shoulder treatment aims to reduce pain, restore movement, and improve shoulder function.

• Medication Therapy: Pain-relieving and anti-inflammatory medicines help reduce pain and improve shoulder comfort.
• Physiotherapy: A structured rehabilitation programme with stretching, strengthening, and mobility exercises restores shoulder movement and flexibility.
• Corticosteroid Injections: Image-guided injections reduce inflammation and improve pain in selected patients.
• Hydrodilatation Procedure: Injection of sterile fluid into the shoulder capsule helps stretch the joint capsule and improve mobility in suitable cases.
• Arthroscopic Shoulder Surgery: Patients with persistent stiffness despite conservative treatment may benefit from minimally invasive arthroscopic capsular release.
• Advanced Orthopaedic Technology: Digital X-rays, MRI, Musculoskeletal Ultrasound, Ultrasound-Guided Injections, Arthroscopy, and Computer-Assisted Rehabilitation support accurate diagnosis and comprehensive shoulder therapy.

Benefits of Early Frozen Shoulder Treatment

Early treatment improves recovery and reduces long-term stiffness.

• Provides Faster Pain Relief: Timely treatment reduces inflammation and improves daily comfort.
• Restores Shoulder Mobility: Rehabilitation gradually improves shoulder movement and flexibility.
• Prevents Severe Joint Stiffness: Early intervention limits progressive tightening of the shoulder capsule.
• Improves Daily Function: Patients regain the ability to perform routine activities more comfortably.
• Reduces Need for Surgery: Most patients recover successfully with early non-surgical treatment.

Complications if Left Untreated

Untreated frozen shoulders may lead to prolonged disability.

• Persistent shoulder stiffness
• Chronic shoulder pain
• Significant reduction in shoulder movement
• Difficulty performing daily activities
• Muscle weakness
• Reduced quality of life
• Delayed recovery

When Should You See a Doctor?

Consult an orthopaedic or shoulder specialist if you experience:

• Shoulder pain lasting more than a few weeks
• Progressive shoulder stiffness
• Difficulty lifting your arm
• Pain affecting sleep
• Reduced shoulder movement after injury or surgery
• Difficulty performing daily activities

Prevention & Lifestyle Modifications

Simple measures help maintain shoulder mobility and reduce recurrence.

• Keep the Shoulder Moving: Gentle movement after injury or surgery helps prevent stiffness when advised by your doctor.
• Perform Regular Stretching Exercises: Daily stretching improves flexibility and maintains joint movement.
• Control Diabetes: Good blood sugar management lowers the risk of adhesive capsulitis.
• Maintain Good Posture: Proper posture reduces unnecessary strain on the shoulder joint.
• Attend Physiotherapy Sessions: Following prescribed rehabilitation improves recovery and prevents long-term stiffness.

Pre–Post Treatment Care

Pre-Treatment

• Orthopaedic consultation
• Physical examination
• X-rays or MRI if required
• Shoulder movement assessment

Post-Treatment

• Physiotherapy programme
• Home stretching exercises
• Gradual return to normal activities
• Pain management as advised
• Regular follow-up with the treating specialist