Frozen Shoulder (Adhesive Capsulitis)
EDP column by Dr Ketan Dhatariya

“I have had a painful, stiff shoulder for a few weeks. My GP tells me I have a frozen shoulder. What is this?”

A frozen shoulder is also known as ‘adhesive capsulitis’. The shoulder joint is enclosed in a fluid filled bag called a capsule. This fluid acts as the lubricant for the joint. Sometimes, the fluid can become inflamed. If this happens the fluid can become very ‘sticky’ making it hard for the joint to move smoothly.

The condition is reasonably common, with up to 1 in 20 people getting it at sometime in their lives, with more people getting it as they get older. More women seem to be affected than men, although it is not clear why this is. Certain things make the condition more likely to occur, such as diabetes, heart disease, chronic bronchitis and Parkinson’s disease. Very rarely it can run in families. It usually occurs on one side only.

There are no special tests that are done to diagnose the condition, other than the story you tell your GP and what they find on examining you.

The condition is almost always painful and leads to a reduction of shoulder movements. It may be associated with some neck stiffness as well. There are three phases to the condition; the ‘freezing stage’, which may last between 6 weeks and nine months, where the loss of shoulder movements and the pain get progressively worse. In the ‘frozen stage’ there is a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months. Finally there is the ‘thawing stage’, during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.

There are a few treatments available, but they all vary in their success rates. Usually the condition gets better on its own. The available treatments aim to minimise pain and maintain shoulder mobility. They include keeping the shoulder as mobile as possible. This can be done with regular exercises, physiotherapy and pain killers. Occasionally it may need an injection of steroids into the joint, or an anaesthetic into the nerves. However, both of these are only temporary measures. If no treatments have helped, or if the condition is prolonged then an operation may become necessary.

For more information about Frozen Shoulder/Adhesive Capsulitis click these links: