Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder is a condition characterised by stiffness of the shoulder joint. It may occur after a shoulder injury (e.g. rotator cuff lesion) but, in many cases, the exact cause cannot be identified. Shoulder movement is restricted due to adhesion and contraction (i.e. scar tissue formation) of the fibrous capsule surrounding the shoulder joint. Frozen shoulder develops in three stages. Painful stage: Pain is the predominant symptom in this initial stage. The patient tends to limit use of the shoulder to avoid the pain. Frozen stage: The pain starts to decrease and stiffness (restricted range of motion) becomes the foremost problem. The stiffness is caused by adhesion and contraction of the capsule surrounding the shoulder joint. Thawing stage: In the third stage, the symptoms subside and the range of motion of the shoulder slowly improves. The thawing stage can take up to 1-1/2 years and much longer.

An X-ray is obtained to rule out bony injury. MRI studies may be performed to assess the damage to soft tissues, if necessary.

Depending on the severity and cause of the stiffness, treatment may be either conservative or surgical.
If capsular inflammation is present, your doctor may prescribe cortisone (local injections or systemic therapy). Cortisone reduces inflammation. At the same time, intensive physiotherapy is needed to restore the range of motion of the joint.
In the advanced stages, your doctor may recommend shoulder manipulation under short anaesthesia. Mobilisation of the shoulder during the brief anaesthesia helps loosen the adhesions.
The bands of tissue (adhesions) on the joint capsule can also be detached surgically in either arthroscopic or open surgery. Here, too, it is important to perform intensive physiotherapy to restore joint mobility and prevent stiffness.
With your input, we will select the method that promises to achieve the best possible short and long-term results for you.