Patient Information Leaflet
Frozen Shoulder (Adhesive Capsultits)
What Causes Frozen Shoulder?
A Frozen Shoulder / Adhesive Capsulitis occurs when there is thickening and
swelling of the flexible tissue that surrounds your shoulder joint. This tissue is
known as a capsule. In cases of frozen shoulder, it is thought that bands of
scar tissue form inside the shoulder capsule, causing it to thicken, swell and
tighten.
Risk Factors for Frozen Shoulder
The reason why a frozen shoulder occurs is not fully understood. It may not
be possible to identify a cause. However, there are risk factors that make
developing a frozen shoulder more likely.
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Shoulder Injury or surgery
Diabetes
Other Health conditions such as heart disease, lung disease,
Parkinson’s disease, stroke or Dupytren’s contracture.
Stages and Signs & Symptoms of frozen shoulder
Stage Duration
1
2
3
Signs and Symptoms
Shoulder
ache;
stiffness;
2 to 9
becoming more painful, pain
months
when lying on it
4 to 12
Increasingly stiff, pain not worse,
months
muscle wasting
5 months to Pain subsides, gradual increase
2- 3 years in movement
Common Problems in Frozen Shoulder
The pain and stiffness that accompanies frozen shoulder can often interfere
with your ability to perform everyday tasks e.g. dressing, bathing, driving.
Shoulder stiffness can mean some activities may become very limited e.g.
scratching your back, putting your hand in a rear pocket, trying a bra, using a
hairdryer, reaching overhead. In some cases work may be affected. In the
painful stage sleep is often affected.
Treatment of Frozen Shoulder
Frozen shoulder is a self-limiting condition that generally gets better by itself.
Treatment can help to ease pain and stiffness and reduce the period of
disability. When receiving treatment for a frozen shoulder it is important to
realise that recovery can be a slow process (up to 3 years) and that
treatments must be given time to work.
Pain management
In the early painful phase, simple painkillers e.g. paracetamol, are the first line
to help control pain. In some cases anti-inflammatories or medication to aid
sleep can be recommended by your doctor to help ease the pain. If in doubt
you should consult your GP or pharmacist before taking any medication.
Physiotherapy
In the early stages physiotherapy is aimed at relieving pain and
maintaining as much movement as possible. As the pain reduces and
stiffness becomes the main problem physiotherapy will aim to increase
the movement as much as possible. Treatments such as joint
mobilisations, stretches, muscle based techniques and other soft
tissue treatments may help relieve pain and improve movement. Other
pain-relieving techniques may include thermal therapy and electrotherapy.
Your physiotherapist will issue you with exercises to help your shoulder
Self-Management
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Use the shoulder – It is very important to use the arm as much as
possible within the limits of your discomfort. Do not stop using it as this
may cause the condition to worsen.
Ice and heat - can be helpful to relieve pain. Be careful of burns.
Pillows - When sleeping try to lie on the unaffected side and place a
pillow under the affected arm to prevent the arm from dropping down.
Exercises - Exercise is advised to maintain available range during all 3
stages.
Medical Management
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A steroid injection can decrease pain and provide relief and its effects can
be maximised using physiotherapy and exercise.
Surgery is rarely used and only should be considered when symptoms are
persistent, debilitating and conservative treatments have failed.