Frozen Shoulder (Adhesive Capsulitis)

What Is Frozen Shoulder?

The joint capsule is a resistant tissue that covers the joints' bones, ligaments, and tendons. Frozen shoulder, or adhesive capsulitis, is when shrinkage of the joint capsule causes the shoulder to become less mobile. This frozen shoulder is usually reversible, but in about one in 10 patients, permanent movement restrictions remain.

Where Does Frozen Shoulder Come From?

The phenomenon of frozen shoulder can have different causes.

Certain metabolic diseases, such as diabetes or dyslipidemia, and hormonal changes can lead to painful inflammatory processes in the synovial membrane. As a result, the patient takes a protective posture, which considerably worsens the situation and strongly drives capsular shrinkage. Patients at risk are people over 40 years of age, and women are particularly affected.

In addition, prolonged shoulder immobilization, such as after surgery or injury, can often lead to a frozen shoulder. To avoid this scenario, patients should undergo passive, or assisted, motion therapy postoperatively to keep the shoulder "free."

Symptoms and Diagnosis

In most cases, frozen shoulder develops in three phases, each lasting several months: First, any movement results in severe pain, limiting active movement. In the next phase, the pain sensation subsides, but the shoulder already stiffens and makes movement difficult. In the last phase, the shoulder's mobility begins to improve again.

The central diagnostic element is the patient interview, through which the physician can already conclude the origin of the problem. The subsequent physical examination is usually sufficient for a diagnosis.

However, an MRI examination may be necessary to determine the exact severity of the inflammatory change in the joint capsule.

How Is Frozen Shoulder Treated?

The gold standard for the treatment of frozen shoulder is conservative treatment. However, this can be a lengthy and exhausting time for the patient.

Conservative Therapy and Exercises

Physiotherapy exercises combined with systematic administration of cortisone to relieve pain and reduce inflammation represent the core of conservative treatment. Pain-free exercises can successfully resolve frozen shoulder conservatively in most cases. In addition, injection of pain-relieving medications into the joint capsule may be indicated.

Frozen Shoulder Surgery

In some patients, the stiffness is severe to the extent that conservative treatment alone is insufficient. Therefore, in some cases, surgical treatment of frozen shoulder becomes necessary. Minimally invasive arthrolysis uses arthroscopy to release the adhesions around the joint. If the stiffness is very accentuated, the joint capsule can also be cut and thus weakened to achieve greater mobility. In arthrolysis, aftercare, in particular, is of considerable importance for the further course. For example, the patient must perform disciplined physiotherapeutic exercises after the surgery to maintain the mobility gained.

Which Doctors and Clinics are Specialized?

To receive the best possible care, patients with frozen shoulders should see specialists in orthopedics and sports medicine, possibly specializing in the shoulder area.

We will help you find an expert for your condition. All listed physicians and clinics have been reviewed by us for their outstanding specialization in frozen shoulder and are awaiting your inquiry or treatment request.