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Frozen Shoulder


Disease: Frozen Shoulder Frozen Shoulder
Category: Bones, joints, muscles diseases
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Disease Definition:

When a person feels stiffness and pain in their shoulder joint, it means that they have a condition called frozen shoulder, which is also known as adhesive capsulitis. The signs and symptoms of this condition begin gradually and worsen over time, then heal. This process usually takes two years.


In case someone has had their arm in a sling for several weeks, or if they've had surgery in which their arm was immobilized for a prolonged time in a specific position, their risk of developing frozen shoulder will increase.


Stretching exercises and injecting numbing drugs and corticosteroids into the joint capsule are some of the ways of treating a frozen shoulder. However, in some rare cases, in order to loosen the joint capsule so that it could move more freely, an operation may be needed.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


In most cases, frozen shoulder develops slowly in three stages; each of these stages may last a few months. These stages include:


  • Painful stage: The shoulder's range of motion starts becoming limited in this stage, and with any movement of the shoulder, pain occurs.
  • Forzen stage: The shoulder becomes stiffer in this stage and the range of motion decreases notably. However, pain could start diminishing.
  • Thawing stage: The shoulder's range of motion begins to improve in this stage.


In some cases, the pain may disrupt normal sleeping patterns in case it worsens at night.


Encased together in a capsule of connective tissue are the bones, ligaments and tendons that make up the shoulder. When this capsule thickens and tightens around the shoulder joint and restricts its movement, frozen shoulder occurs.


Despite the fact that frozen shoulder is more likely to occur in people who've recently experienced prolonged immobilization of their shoulder, such as after arm fracture, or after a surgery, however, why this occurs in some people and not in others is still not clear. There could be an autoimmune basis to the disease, because frozen shoulder occurs more in people with diabetes.





Controlling shoulder pain and preserving as much range of motion in the shoulder as possible are some of the ways of treating frozen shoulder.




During the initial painful phase, the duration of symptoms may be shortened and the pain decreased if the person gets injected with these anti-inflammatory medications. However, it is not recommended to repeat corticosteroid injections.



The pain and inflammation that are associated with frozen shoulder could be relieved by these nonsteroidal anti-inflammatory drugs. Yet another medication that could be effective for pain relief is acetaminophen .



In order to help maintain as much mobility in the shoulder as possible without stressing it to the point of causing a lot of pain, a physical therapist could teach the patient some specific exercises.



Shoulder manipulation:

In this procedure, the shoulder joint will be moved in ways that help loosen the tightened tissue, before which the patient will be given general anesthesia.



In order to help stretch the tissue and make it easier to move the joint, sterile water will be injected into the joint capsule.



In some cases, surgery could be an option for removing scar tissue and adhesions from inside the shoulder joint, particularly if the symptoms haven't improved despite other measures. Usually, this surgery is performed arthroscopically, in which a lighted, tubular instrument is inserted in the joint through a small incision.


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