Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint (the capsule) becomes inflamed and thickened, leading to adhesions and a progressive reduction in movement.

Causes of Frozen Shoulder

The exact cause of frozen shoulder is not always clear, but several factors are associated with its development:

1. Primary (Idiopathic)
   • The cause is unknown and occurs spontaneously, often without any clear trigger.
2. Secondary (Associated with Other Conditions)
   • Prolonged Shoulder Immobilization: Following surgery, injury, or fractures, the lack of movement can lead to adhesions forming in the shoulder capsule.
   • Diabetes: People with diabetes are at significantly higher risk, although the exact reason is unclear.
   • Thyroid Disorders: Hypothyroidism and hyperthyroidism can increase risk.
   • Other Medical Conditions: Parkinson’s disease, cardiovascular disease, and certain autoimmune conditions may contribute to the development of frozen shoulder.
3. Inflammatory or Overuse Injuries
   • Chronic inflammation from rotator cuff injuries, bursitis, or tendinitis can predispose individuals to frozen shoulder.
4. Age and Gender
   • More common in individuals aged 40–60 and occurs more frequently in women than men.

Phases of Frozen Shoulder

1. Freezing Phase (Painful Stage):
   • Progressive pain that worsens over time, with increasing stiffness.
   • Range of motion begins to decrease.
2. Frozen Phase (Stiff Stage):
   • Pain may decrease, but stiffness becomes more prominent, severely limiting motion.
3. Thawing Phase (Recovery Stage):
   • Gradual improvement in shoulder mobility and reduction in stiffness.

The entire process may last between 12–24 months.

Treatment for Frozen Shoulder

Non-Surgical Treatments

1. Pain Management
   • Over-the-counter pain relievers like acetaminophen or NSAIDs (e.g., ibuprofen, naproxen) for pain and inflammation.
   • Corticosteroid injections into the shoulder joint to reduce severe pain and inflammation.
2. Physical Therapy
   • Gentle stretching exercises to restore mobility (avoid over-aggressive stretching, which can worsen the condition).
   • Techniques to improve joint movement, including heat application before exercises.
3. Hydrodilatation (Distension Arthrography)
   • Injection of sterile fluid into the joint capsule to stretch it and improve mobility.
4. Activity Modification
   • Avoid activities that aggravate the condition while maintaining light movement to prevent further stiffness.
5. Heat and Ice Therapy
   • Heat helps relax muscles and prepare for stretching, while ice can reduce inflammation after activity.

Surgical Treatments

If conservative treatments fail after several months, surgical options may be considered:

1. Manipulation Under Anesthesia (MUA)
   • The shoulder is gently moved through its range of motion while the patient is under anesthesia to break adhesions.
2. Arthroscopic Capsular Release
   • A minimally invasive procedure where tight portions of the joint capsule are cut to restore mobility.

Home Exercises

1. Pendulum Exercises:
   • Let your arm hang down and gently swing it in small circles.
2. Cross-Body Stretch:
   • Use the unaffected arm to gently pull the affected arm across your chest.
3. Wall Crawling:
   • Use your fingers to “crawl” up a wall, gradually increasing the range of motion.
4. Towel Stretch:
   • Hold a towel behind your back with both hands, and gently pull to stretch the affected shoulder.

Preventive Measures

• Early mobilization of the shoulder after injury or surgery to avoid prolonged immobilization.
• Control risk factors like diabetes or thyroid disorders through proper medical care.
• Engage in regular stretching and strengthening exercises to maintain joint flexibility.

If you suspect frozen shoulder due to persistent pain or stiffness, consult an orthopedic specialist or physical therapist for an accurate diagnosis and personalized treatment plan.