This information is useful for those who have been diagnosed with a frozen shoulder. People who are experiencing new or ongoing symptoms should contact their healthcare professional.
What is a Frozen Shoulder?
Frozen shoulder is a condition that leads to pain and stiffness of the shoulder. It's also known as adhesive capsulitis or shoulder contracture.
Typically, you'll experience shoulder pain which can become more severe over a number of months. This is usually followed by increasing stiffness.
The stiffness may affect your ability to carry out everyday activities. In particularly severe cases, you may not be able to move your shoulder at all.
What causes a Frozen Shoulder?
Frozen shoulder occurs when the flexible tissue that surrounds the shoulder joint, known as the capsule, becomes inflamed and thickened. It's not fully understood why this process happens. This can happen in one or both shoulders.
This condition can appear without any apparent reason, however, your risk of developing a frozen shoulder can increase if you have:
- a previous shoulder injury or shoulder surgery
- diabetes or a thyroid problem
- Dupuytren's contracture – a condition where small lumps of thickened tissue form in the hands and fingers
- other health conditions, such as heart disease and stroke
What are the symptoms of a Frozen Shoulder?
Pain and persistent stiffness in the shoulder joint are the two main symptoms of a frozen shoulder.
This makes it painful and difficult to carry out the full range of normal shoulder movements. You may find it difficult to perform everyday tasks, such as:
- sleeping comfortably
Symptoms vary from mild, with little difference to daily activities, to severe, where it may not be possible to move your shoulder at all.
Stages of frozen shoulder
The symptoms of a frozen shoulder usually get worse gradually, over a number of months.
There are three separate stages to the condition but sometimes these stages may be difficult to distinguish. The symptoms may also vary greatly from person to person.
During stage one, often referred to as the "freezing" phase, your shoulder starts to ache and can become very painful, for example, when reaching out for things.
The pain is often worse at night and when you lie on the affected side. This stage can last anywhere from 2-9 months.
Stage two is often known as the "frozen" phase. Your shoulder may become increasingly stiff, but the pain doesn't usually get worse and may even decrease.
The stiffness in your shoulder can continue to affect your day to day activities. This stage usually lasts 4-12 months.
Stage three is known as the "thawing" phase. During this period, you'll gradually regain movement in your shoulder.
If pain is still present it should start to fade, although it may come back occasionally as the stiffness eases. This stage can last 12 months or more.
In order for a frozen shoulder to be diagnosed you'll need an assessment from a healthcare professional.
They'll initially ask you questions about your shoulder issue and then carry out a physical examination. This will include checking your range of movement and strength.
You may sometimes need to have a further examination to rule out other possible health conditions.
Treatment options depend on the severity of your symptoms. Although, most cases improve on their own, some cases can take over a year to resolve.
During the painful phase the emphasis is on pain relief. Pain medication can help you move more comfortably, which can help your recovery.
More about taking painkillers.
It may also help to use heat or ice packs.
Targeted shoulder exercises to encourage movement, stretching and strengthening exercises can help to improve your arm movement and pain.
The British Elbow and Shoulder Society have a video with specific exercises to help with a frozen shoulder.
Stop these exercises if they make your symptoms worse, or if they cause new pain.
If your shoulder pain worsens while following this advice, it’s a good idea to talk to a healthcare professional about your symptoms.
If painkillers aren't helping to control the pain, your healthcare professional may discuss the option of having a corticosteroid injection into your shoulder joint.
Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic.
Injections won't cure your condition or reduce shoulder stiffness, they are used to help with the pain.
It's recommended you stay at or return to work as quickly as possible during your recovery, however, you may need to modify your everyday duties. This should be discussed with your employer.
You don’t need to be pain and symptom free to return to work.
Help and support
Following this advice, you should see gradual improvements over time.
If your frozen shoulder hasn’t improved, or it's got worse, within 6 weeks of following this advice, talk to a healthcare professional about your symptoms.
Find out how to access MSK services in your area.
When dealing with any health condition it's important to also look after your mental wellbeing as this can impact your recovery.
Source: MSK Expert Panel
22 March 2023
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