Frozen Shoulder: Causes, Symptoms, Stages, Treatment and Prevention


Frozen shoulder is a painful and frequently incapacitating condition. Although the reason for frozen shoulder is unknown, there are possible treatments that benefit the vast majority of patients. In this post, we will look at the phases of frozen shoulder and discuss frozen shoulder physiotherapy treatment and prevention.

What Exactly is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, is a condition which causes shoulder stiffness and lack of mobility.

The shoulder is a complicated joint that trades stability for a wide range of motion. Inflammation of the tissues around the joint characterises frozen shoulder. The capsule refers to the tissues that surround and hold the joint together. In a frozen shoulder, the capsule becomes inflamed, producing scarring and tightness of the joint, resulting in discomfort and mobility limits.

Frozen Shoulder: What Causes It?

The exact cause of the frozen shoulder is unknown. However, the following risk factors are linked to the development of a frozen shoulder:

  • Diabetes mellitus 
  • Stroke
  • Thyroid disease
  • Shoulder injury
  • Dupuytren’s syndrome
  • Parkinson’s disease
  • Complex regional pain syndrome in cancer

Females are four times more likely than guys to have frozen shoulders.

It is more frequent in adults aged 40 to 60. Because this issue might mimic other shoulder problems in its early stages, acquiring the correct diagnosis is critical.

What are the Symptoms of a Frozen Shoulder?

While there is usually no traumatic, infectious, or inflammatory event, clients will report new shoulder discomfort and mobility limitation. The pain is generally localised around the shoulder and becomes worse at night.

The Three Stages of Frozen Shoulder

Frozen shoulder is commonly classified into three phases of symptoms:

  • The Freezing Stage – There is a lot of inflammation in and around the joint at this stage, which causes intense discomfort and moderately restricted movement. Shoulder motions are restricted in both active and passive movements and are characterised by limited shoulder movement directions. This period might extend between 2 and 4 months.
  • The Frozen Stage – The frozen stage can continue anywhere from 4 to 12 months. The early stages can be uncomfortable, but later on, there is a significant reduction in the range of motion. Pathologically, this is characterised by reduced inflammation and extensive fibrosis (scarring) of the capsule and ligaments.
  • The Thawing Stage – During the third stage, there is minimal discomfort and a gradual recovery of mobility as the inflammation and scarring diminish. This stage might extend for as long as 26 months.

What Helps to Prevent a Frozen Shoulder?

Although the causes of frozen shoulder are uncertain, immobilisation after shoulder surgery or an accident might contribute to its development in certain situations. Movement guides and pain management are critical for keeping the shoulder flexible after surgery or damage.

Physiotherapy for Frozen Shoulder

Physiotherapy for frozen shoulder is determined by the stage and symptom presentation. Therefore, patient education, pain management, and moderate stretching exercises are all part of early intervention. These exercises include particular shoulder mobilisation movements designed to keep the shoulder range of motion within a pain-free range.

Later phases of treatment may include further stretching exercises, postural exercises, strengthening, and pain management approaches. Acupuncture, heat, ultrasound, shockwave treatment, and manual therapy are all methods of pain management.

A home exercise regimen is also advised to maintain shoulder mobility and strength during the various phases. Hydrotherapy can also aid in maintaining shoulder mobility in a pain-free environment.