Frozen Shoulder - How to escape the stiff shoulder.
- Mar 29
- 5 min read
Updated: 2 days ago
Frozen shoulder is a painful condition affecting the shoulder joint. The condition is also known as adhesive capsulitis.
Frozen shoulder affects approximately 2% to 5% of the population and occurs more frequently in women than in men.
Frozen shoulder typically affects people between the ages of 40 and 60 and is more common in people with certain medical conditions such as diabetes or thyroid disease.
In this article you will learn:
Definition of shoulder stiffness
Typical symptoms of shoulder stiffness.
This is how adhesive capsulitis is diagnosed.
This is the typical progression of frozen shoulder.
These are the treatment options for adhesive capsulitis.
1. The definition of shoulder stiffness.
Frozen shoulder is a condition that affects the shoulder joint and causes pain and stiffness.
It occurs when the tissue surrounding the shoulder joint (shoulder capsule) becomes thick and tight, and scar tissue forms within it. This reduces the space within the joint, making movement difficult and causing pain.
Shoulder stiffness can occur without any identifiable cause (idiopathic), after injuries, or after surgical procedures. Symptoms depend on the severity and stage of the disease.
2. Typical symptoms of shoulder stiffness.
The symptoms of a frozen shoulder develop gradually over time.
The main symptom is pain, which increases in intensity over time. Initially, the pain occurs when twisting the shoulder, for example, when putting on a jacket or reaching for the seatbelt in a car.
Over time, even the smallest shoulder movements become painful, disrupting daily life and sleep. In addition to the pain, the shoulder becomes increasingly restricted in its mobility, further impairing quality of life.
3. This is how adhesive capsulitis is diagnosed.
The diagnosis of frozen shoulder is based on a physical examination and medical history.
The diagnosis of frozen shoulder is based on a physical examination and medical history. Therefore, the diagnosis is primarily made clinically.
During the physical examination, the doctor checks the range of motion of the shoulder and looks for signs of pain or stiffness.
In particular, rotation of the shoulder is limited when the capsule is tense compared to the opposite side. Patients can easily check this by comparing the two sides by trying to move their thumb upward behind their back.
X-rays or an MRI may be ordered to rule out other conditions, such as a rotator cuff tear . While an X-ray is usually unremarkable, in advanced stages, an MRI may show thickening of the joint capsule and increased signal intensity in the rotator cuff.
4. This is the typical progression of frozen shoulder.
Level 1: Freezing level
During this phase, the shoulder is painful and movement is restricted. This phase can last between 2 and 9 months. The pain is usually located in the outer shoulder area and can be severe at night, disrupting sleep.
Stage 2: Frozen Stage
During this phase, pain may subside, but the shoulder will become stiffer. This phase can last between 4 and 12 months. The stiffness can make it difficult to perform everyday activities such as dressing and reaching overhead.
Stage 3: Thawing phase
During this phase, the range of motion in the shoulder gradually improves and pain subsides. This phase can last between 6 and 24 months.
5. These are the treatment options for adhesive capsulitis.
Gentle stretching exercises and avoiding pain-inducing activities are important components of therapy, along with the belief that this condition usually heals benignly on its own.
The goal of treating a frozen shoulder is to relieve pain and restore mobility in the shoulder. Treatment options may include:
Physiotherapy and osteopathy
Physical therapy is often the first-line treatment for frozen shoulder. A physical therapist can teach you exercises to stretch and strengthen the shoulder joint. These exercises can help improve range of motion and reduce pain.
Unfortunately, during the freezing phase, forced movement of the shoulder is often painful, so that patients find the therapy in this acute phase to be of little benefit or counterproductive.
In the later stages of adhesive capsulitis, however, targeted physiotherapy is very helpful in restoring shoulder mobility.
Osteopathy can help improve the basic condition of the shoulder and temporarily increase the quality of life.
Medications
Painkillers such as ibuprofen or metamizole can help relieve shoulder pain and inflammation. If the pain is severe, your doctor may prescribe stronger painkillers.
Taking cortisone tablets in a step-by-step regimen has shown relief of symptoms in some studies, but many patients complain of typical side effects such as restlessness, heartburn or skin rash.
In contrast, a corticosteroid injection into the shoulder joint can be a targeted treatment with few side effects. Several studies have demonstrated pain relief and improved quality of life with comparatively fewer side effects.
Home remedies
It's worth trying various home remedies to relieve the symptoms of a frozen shoulder. These include alternating heat and cold (skin protection) on the shoulder. Some patients benefit from quark or arnica compresses.
Gentle stretching exercises and avoiding pain-inducing activities are important components of therapy, along with the belief that this condition usually heals benignly on its own.
Interventions
Due to the frequency and duration of its course, adhesive capsulitis is the subject of numerous research projects.
These include transarterial periarticular empolization (TAPE) and oral therapy with mast cell stabilizers to reduce the synthesis/release of growth factors and mast cell mediators in the shoulder joint capsule. Treatment with various antibiotics has also been attempted.
Since the studies do not yet show long-term results, too little is known about the benefits and risks of these treatment options to make a recommendation.
Minimally invasive surgery
Surgery is only necessary in very rare exceptional cases when treating frozen shoulder.
During the operation, the scar tissue in the shoulder joint is removed along with a strip of the joint capsule, allowing for improved freedom of movement.
Surgery is usually only considered when all other treatments have failed.
Since this condition can take up to three years to heal spontaneously, a great deal of patience is required. In most cases, premature surgery results in disappointing outcomes for many patients.
Surgery is only necessary in very rare exceptional cases when treating frozen shoulder.
Prevent
It's impossible to prevent frozen shoulder. But there are some things you can do to reduce the risk of developing it and the severity of symptoms. These include:
Stay physically active and maintain a healthy weight. Avoid repetitive shoulder movements that can lead to strain or injury.
Practice good posture and ergonomics at work and at home.
The treatment of underlying diseases such as diabetes or thyroid diseases appears to be sensible in view of the above-mentioned connections, but a direct effect on the acute disease cannot be clearly proven.
When the condition occurs, try not to exercise to relieve the pain. Gentle stretching exercises and avoiding pain-inducing activities are preferable to a categorically protective posture. Walking, jogging, and swimming (if possible) can help reduce the overall feeling of illness. So try to stay mobile.
Conclusion:
Frozen shoulder is a painful condition that can affect anyone, but it is more common in women and people with certain medical conditions.
The condition typically develops gradually over time and is characterized by pain and stiffness in the shoulder joint.
Treatment options include tablets and infiltrations, physiotherapy, osteopathy, gentle stretching and waiting.
Surgery is only necessary in rare exceptional cases.
If you have symptoms of a frozen shoulder, it is advisable to consult a doctor for a diagnosis
Do you have shoulder pain and are unsure what the cause is?
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