A stiff painful shoulder is called a “frozen shoulder” if there is no cause (trauma/fracture/surgery) identified for the stiffness. It is sometimes called adhesive capsulitis or a contracted shoulder.
Pain, often severe, and stiffness come on over a period of weeks or months as the shoulder condition progresses through its initial stage of “freezing”. The shoulder then becomes “frozen” and remains stiff while pain can subside. Following this the shoulder stiffness slowly resolves as the shoulder “thaws”. The whole process can be slow and take 2 years or longer.
Frozen shoulder is more common in women than men and classically occurs between 40 and 60 years of age. It is more common in individuals with diabetes, thyroid and heart disease, and is associated with Dupuytren’s disease (that affects the hands and feet). Stiffness in patients over 65 may indicate shoulder arthritis and an X-ray should be arranged to confirm the diagnosis of arthritis.
Patients should be aware of the natural history of resolution over time, but intervention should be considered if symptoms are interfering in daily life and/or sleep.
The treatment options of frozen shoulder include a steroid injection into the shoulder joint, a distension (stretching) injection of the shoulder joint or keyhole surgery to release the tight capsule (arthroscopic arthrolysis). The pros and cons of these can be discussed at your consultation.