• Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
  • The head of the upper arm bone fits into a shallow socket in your shoulder blade. Strong connective tissue, called the shoulder capsule, surrounds the joint.
  • To help your shoulder move more easily, synovial fluid lubricates the shoulder capsule and the joint.
  • Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes progressively harder to move.
  • In frozen shoulder, the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
  • The hallmark signs of this condition are severe pain and being unable to move your shoulder — either on your own or with the help of someone else. It develops in three stages:
    • Freezing: In the "freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
    • Frozen: Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.
    • Thawing: Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
  • Not fully understood
  • A few factors can put you at greater risk:
    • Diabetes
    • Hypothyroidism
    • Hyperthyroidism
    • Parkinson’s disease
    • Cardiac disease
  • Immobilization
    • After surgery
    • After a fracture
    • After other injuries to the shoulder
  • Usually the pain is described as dull and achy to none at all
  • Generally after a period of immobilization
  • Inability to move the shoulder fully

Nonsurgical Treatment

Treatment for Frozen shoulder syndrome relies greatly on gaining the range of motion back in the shoulder. This is a progressive condition and it can take over one year to full recover. Physiotherapy is important to create exercises and stretching to meet these goals.

  • Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling. Like any over the counter medication, please read and follow the label. If you have a history of stomach ulcers, bleeding ulcers or heart conditions, these medications might not be right for you. Consult your physician if you have any questions.
  • Physiotherapy. Under the direction of an experienced physiotherapists, many patients do well by:
    • Increasing Range of motion exercises and flexibility
    • Massage and TENS
  • Topical anti-inflammatories
    • Compound Topical Creams
    • Voltaren
  • Injections
    • Steroid (Depo-Medrol, Kenalog, Decadron)
    • Blood (PRP – Platelet Rich Plasma)

Surgical Treatment

  • Usually the symptoms associated with frozen shoulder are self-limiting
  • Under the direction of your surgeon, you may benefit from the following surgeries:
    • Manipulation under anesthesia. You are put asleep and the surgeon will manipulate your arm to create more range of motion.
    • Shoulder arthroscopy