Adhesive capsulitis (frozen shoulder)

Back to Patient education: shoulder

What is adhesive capsulitis?

Adhesive capsulitis, also known as frozen shoulder, is a condition characterized by pain and stiffness in the shoulder joint. The bones, ligaments and tendons that make up your shoulder joint are encased in strong connective tissue called the shoulder capsule. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

Frozen shoulder develops in three stages:

  • In the freezing stage, pain intensifies in the shoulder joint and you lose range of motion.
  • In the frozen stage, the pain may lessen, but significant stiffness remains and daily activities are difficult.
  • In the thawing stage, shoulder motion slowly improves and eventually returns to normal.

Watch a video on the three stages

What causes adhesive capsulitis?

The exact cause of frozen shoulder is unknown. However, certain factors raise your risk, including diabetes or thyroid disease, prolonged immobility of the shoulder following injury or surgery, and aging. Adults over 40 are more prone to frozen shoulder.

What are the symptoms?

The most common symptom is inability to move the shoulder. Other symptoms include pain, stiffness and inflammation. For some people, pain worsens at night and can disrupt sleep.

How is adhesive capsulitis diagnosed?

Because many shoulder conditions can mimic adhesive capsulitis, it is important that you consult a qualified physician to assess your symptoms. In addition to a patient history and examination, your doctor may order imaging tests—such as an X-ray or MRI—to evaluate the condition of your shoulder and rule out other problems.

What is the treatment?

Most cases of frozen shoulder get better on their own. Simple, non-operative treatments including over-the-counter medications, corticosteroid injections, rehabilitation exercises, and physical therapy can help reduce pain and inflammation. In some cases, your surgeon may perform shoulder manipulation while you are under anesthesia to help loosen tightened tissue and increase range of motion.

In rare cases, surgery is recommended to remove scar tissue and adhesions from inside your shoulder joint. In this minimally invasive procedure, called shoulder arthroscopy, the surgeon makes several small incisions around the joint, inserts a narrow fiber optic scope, and uses tiny instruments to stretch or release the shoulder’s contracted joint capsule.

Following surgery, physical therapy is necessary to regain your range of motion. Recovery time varies depending on the severity of your condition, and ranges from six weeks to three months.