Adhesive Capsulitis (Frozen Shoulder)

Adhesive capsulitis, commonly called frozen shoulder, is a condition characterized by progressive shoulder pain and stiffness due to inflammation and contraction of the shoulder joint capsule. It typically progresses through three stages: freezing (painful), frozen (stiff), and thawing (recovery). It is more common in women, diabetics, and those aged 40–60.

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Typical Recovery Time

12–24 months for natural resolution; intervention shortens this significantly

Symptoms

•Gradual onset of shoulder pain (freezing phase)
•Severe restriction of both active and passive shoulder motion
•Pain at end range of motion in all directions
•Night pain
•Difficulty with overhead, behind-the-back, or reaching activities

Common Causes

•Idiopathic (no identified cause)
•Diabetes mellitus (strong association)
•Prior shoulder injury or surgery
•Prolonged immobility
•Thyroid disease

Treatment Options

1NSAIDs and moist heat in early stages

2Physical therapy (gentle stretching, not aggressive)

3Corticosteroid injection (most effective in freezing phase)

4Hydrodilatation (joint distension injection)

5Manipulation under anesthesia or arthroscopic capsular release for refractory cases

When to See a Doctor

See a provider early — frozen shoulder is much easier to treat in the freezing stage than the frozen stage.

Frequently Asked Questions

What is frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, is a condition where the shoulder becomes stiff and painful due to tightening of the joint capsule. Movement gradually becomes limited over time. It often develops without a clear injury.

What causes frozen shoulder?

It can develop after injury, surgery, or periods of immobility. It is also more common in people with diabetes or thyroid conditions. Sometimes the exact cause is not clear.

What are the symptoms?

Symptoms include progressive shoulder stiffness and pain that worsens with movement. Over time, it becomes difficult to lift or rotate the arm. The condition often goes through painful and stiff phases.

How is frozen shoulder treated?

Treatment focuses on restoring motion with physical therapy and stretching exercises. Medications or injections may help reduce pain. In severe cases, procedures may be considered to improve mobility.

How long does recovery take?

Recovery can take several months to over a year. Most patients gradually regain motion with consistent treatment. Return to full activity depends on regaining flexibility and strength.

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