Frozen shoulder

What it is

Frozen shoulder (also known as adhesive capsulitis) is a common condition that causes pain and progressive stiffness of the shoulder. Many people first notice discomfort at night or difficulty reaching overhead, fastening a bra, putting on a coat or reaching behind their back. Over time, the shoulder can become increasingly stiff, making even simple everyday activities challenging. The exact cause of frozen shoulder is not fully understood, and in many cases it develops without any obvious injury. It is more common between the ages of 40 and 60 and is particularly associated with diabetes, thyroid disorders and, occasionally, following an injury or period of shoulder immobilisation.

How it usually presents

• Discomfort at night or difficulty reaching overhead
• Difficulty fastening a bra, putting on a coat or reaching behind your back
• Increasing stiffness that makes everyday activities challenging
• A condition that is usually self-limiting, but can take many months and sometimes two to seven years to improve
• Not everyone regains full movement without treatment

How it is assessed

The first step is to make sure the diagnosis is correct. Several other shoulder conditions can mimic frozen shoulder, and it is important to distinguish these before deciding on treatment. A careful history, examination and simple X-rays are often all that are needed to confirm the diagnosis and exclude other causes of shoulder pain.

Treatment options

• Pain relief
• Specialist physiotherapy and stretching programmes
• Ultrasound-guided injections or hydrodilatation to help improve pain and movement
• Keyhole surgery in a small number of patients if symptoms remain severe despite non-surgical treatment

Not sure whether your symptoms are due to a frozen shoulder? Shoulder stiffness can have a number of different causes. If your shoulder pain or loss of movement is affecting your daily life, I'd be happy to assess your shoulder, explain the diagnosis and discuss the treatment options that are most appropriate for you.