Frozen Shoulder

Autor: RAFAŁ CZEPUŁKOWSKI
Consultation NATALIA REKE
Date added 14.12.2024
Date of last revision 14.12.2024

Table of contents:

Frozen Shoulder – also known as Adhesive Capsulitis (AC), can be a common cause of chronic shoulder pain. It affects approximately 2-5% of the population, predominantly women. Although it is a treatable condition, recovery takes a long time, significantly hindering daily activities. Moreover, some patients may experience this condition in the opposite shoulder, which can resolve spontaneously over a period of a few months to two years.

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What is Frozen Shoulder?

Frozen Shoulder is a condition characterized by a significant limitation of shoulder joint mobility accompanied by increasing pain, primarily associated with arm movement, but also occurring at rest, such as during the night.

Symptoms of Frozen Shoulder

Primary adhesive capsulitis refers to cases without clear causative factors, such as sudden trauma or previous surgery, which might contribute to dysfunction. Imaging and histopathological studies suggest that Frozen Shoulder is an inflammatory condition involving the synovial membrane and fibrotic thickening of the joint capsule. Collagenous tissue, resembling scar tissue, forms. The vascularization and innervation of this new tissue explain why Frozen Shoulder is so painful and leads to stiffness.

A hallmark of adhesive capsulitis is extreme pain without significant tissue damage.

Causes of Frozen Shoulder

The exact causes of this condition remain unclear, but it is observed that Frozen Shoulder often correlates with conditions such as diabetes, Parkinson’s disease, cardiovascular, immunological, biochemical, or hormonal disorders. This issue primarily affects middle-aged women. Notably, severe or prolonged stress frequently appears in medical histories, even weeks or months before the onset of pain and the sudden progressive limitation of shoulder mobility, without trauma or overuse.

To date, no correlation has been identified between personality type and the risk of developing this condition or predicting treatment outcomes. Frozen Shoulder, with its prolonged and debilitating symptoms, can have a negative impact on the patient’s overall well-being.

The Three Phases of Frozen Shoulder

Freezing Phase – Lasting from 1 to 8 weeks.
Initially, pain occurs during daily activities, which the patient often interprets as minor overuse. This is followed by painful movement restriction. In some cases, the sequence of pain and stiffness onset can be reversed. Pain makes it impossible for the patient to sleep on the affected shoulder. Recent studies highlight external rotation as the first movement to become restricted.

Frozen Phase – Lasting from 9 to 16 months.
Resting pain decreases, though nocturnal pain may persist. However, stiffness progresses, and patients report difficulties with simple daily tasks, such as fastening a bra or reaching for a seatbelt in the car.

Thawing Phase – Lasting from 12 to 40 weeks.
Joint mobility gradually returns on its own. However, incomplete recovery is often observed, and the condition may recur in the opposite shoulder.

Treatment of Frozen Shoulder

Early symptoms of Frozen Shoulder should not be ignored. Prompt physiotherapy intervention can facilitate a smoother recovery process. The treatment focuses on physiotherapy methods such as:

  • Working on soft tissues, including trigger points,
  • Working along muscle grooves,
  • Fascial therapy (e.g., FDM),
  • Deep tissue massage,
  • Manual therapy,
  • Pain-relieving and stiffness-reducing exercises,
  • Relaxation techniques and breathing exercises.

Patient commitment and systematic rehabilitation, supported by proper education, play a significant role in reducing pain and restoring full functionality.

In extreme cases, when conservative treatment fails to deliver satisfactory results, procedures such as injections with pain-relieving and anti-inflammatory agents, saline solutions, or, as a last resort, surgical intervention may be considered. Surgical treatment involves cutting the joint capsule to release the shoulder. Immediate mobilization and intensive rehabilitation are essential after surgery.

Rehabilitation Program After Surgical Treatment of Frozen Shoulder

Based on extensive experience and collaboration with leading Polish orthopedic surgeons, we have developed advanced rehabilitation programs to help you safely and quickly regain maximum functionality after surgery.

Remember, surgery is only half the battle; the success of your recovery depends on the rehabilitation process and your dedication. Rehabilitation after surgical treatment of Frozen Shoulder typically lasts about 24 weeks. However, this period may vary and will be adjusted based on your progress by your doctor and physiotherapist.

Related Articles:
Learn more about other possible shoulder injuries and conditions.

Bibliography:

Autor
RAFAŁ CZEPUŁKOWSKI
RAFAŁ CZEPUŁKOWSKI

Specjalista do spraw content marketingu, dziennikarz sportowy i medyczny. Redaktor naczelny magazynu „Poradnik Zdrowie i Sport”, członek Dziennikarskiego Klubu Promocji Zdrowia, współtwórca wielu artykułów medycznych z zakresu ortopedii i urazowości w sporcie.

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Konsultacja merytoryczna
NATALIA REKE
NATALIA REKE

Fizjoterapeutka w Rehasport, specjalistka od terapii bólu, stanów przeciążeniowych kończyny górnej i dolnej. Zajmuje się neurodynamiką (pracą na nerwach, koordynacji i sile mięśniowej) problemami kręgosłupa (dyskopatii, dysfunkcji stawowych), a także rehabilitacją kobiet w ciąży.

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