What Is a Frozen Shoulder?
A frozen shoulder, also known as adhesive capsulitis, is a painful condition in which the capsule surrounding the shoulder joint becomes thicker, tighter, and less flexible. As the joint capsule stiffens, the range of motion in the shoulder gradually becomes more limited.
The shoulder consists of a ball-and-socket joint. Surrounding the joint is a capsule that provides stability while allowing movement. The lining of the joint produces synovial fluid, which helps the shoulder move smoothly. In a frozen shoulder, the capsule becomes irritated and stiff, leading to both pain and a significant loss of mobility.
A key characteristic of a frozen shoulder is that the shoulder is not only difficult to move on your own. Even when someone else gently moves your arm, the range of motion remains restricted. Rotating the arm outward and lifting it above shoulder height are often the most difficult movements.
Causes of a Frozen Shoulder
A frozen shoulder can develop without a clearly identifiable cause. This is known as primary frozen shoulder. In some cases, it develops after the shoulder has been used very little for an extended period. This may occur after a fall, surgery, a fracture, or another shoulder injury.
Repeated strain or maintaining the same posture for long periods may also contribute to shoulder irritation. However, it is not always possible to determine exactly why the joint capsule has become stiff and painful.
Factors That May Increase the Risk
- A previous fall or shoulder injury
- Surgery involving the shoulder or arm
- Long periods of limited shoulder movement
- Another painful shoulder condition
- Diabetes
- Certain thyroid disorders
Frozen shoulder most commonly affects middle-aged adults, although it can occur at other ages as well.
Symptoms of a Frozen Shoulder
The two main symptoms are pain and a gradually decreasing range of motion. The way symptoms develop varies from person to person and depends partly on the stage of the condition.
- A painful and stiff shoulder
- Difficulty lifting the arm
- Difficulty rotating the arm outward
- Difficulty placing the hand behind the back
- Pain along the outside of the upper arm
- Shoulder pain that is worse at night
- Pain during sudden or unexpected movements
- Difficulty dressing, driving, or washing your hair
The Three Stages of a Frozen Shoulder
A frozen shoulder usually develops in three stages. The duration and severity of each stage vary from person to person, and the stages gradually overlap.
Freezing Stage
During the freezing stage, pain gradually increases while shoulder movement becomes more restricted. Pain may also occur at rest and is often most severe at night. Sudden movements, lifting the arm, and rotating the shoulder outward can cause sharp pain.
Frozen Stage
During the frozen stage, the restriction in movement is usually at its greatest. Pain often gradually decreases, but the shoulder remains stiff. Everyday activities such as putting on a jacket, reaching for an object on a shelf, or placing your hand behind your back may remain difficult.
Thawing Stage
During the thawing stage, pain continues to decrease and shoulder mobility gradually improves. Recovery usually happens slowly, and it may take a considerable amount of time before the shoulder can be used normally or almost normally again.
Diagnosis of a Frozen Shoulder
A doctor or physiotherapist can often diagnose a frozen shoulder based on the pattern of your symptoms and a physical examination of the shoulder. During this examination, they assess which movements are restricted and whether the shoulder remains stiff when the examiner gently moves your arm.
An X-ray or scan is usually not required to diagnose a frozen shoulder. However, additional imaging may be recommended if there is uncertainty about the diagnosis or if another cause of the shoulder pain needs to be ruled out.
Treatment and Recovery of a Frozen Shoulder
A frozen shoulder usually improves gradually, but recovery can take several months and sometimes even a few years. Treatment mainly focuses on relieving pain while maintaining or gradually improving the range of motion.
Continue to use your shoulder within your pain limits. Complete rest or prolonged immobilization can actually increase stiffness. At the same time, it is not advisable to force the arm through severe pain. The appropriate level of activity depends on the stage of the condition and varies from person to person.
A physiotherapist can guide you with suitable exercises and provide advice on using your arm during daily activities. If the pain is severe, your doctor can determine which form of pain relief is most appropriate.
Support with a Shoulder Brace
A shoulder brace can provide temporary support during everyday activities. It may help you use your shoulder more consciously and reduce sudden or strenuous movements. This can be particularly helpful if movement feels painful or uncertain.
A brace does not make the joint capsule more flexible or cure a frozen shoulder. Its primary purpose is to provide temporary support without completely immobilizing the shoulder. Gentle movement within your pain limits remains an essential part of recovery.
Why Can a Shoulder Brace Help?
- Provides temporary support to the shoulder joint
- Helps reduce sudden and strenuous movements
- May increase confidence during daily activities
- Makes it easier to control shoulder loading
- Allows controlled shoulder movement
What Should You Consider When Choosing a Shoulder Brace?
Choose a shoulder brace that fits properly and provides support without completely immobilizing the shoulder. The brace should not feel too tight and should allow enough freedom for gentle movement. Adjustable straps make it easier to tailor the fit and level of support to your individual needs.
A sling keeps the arm largely immobilized and is therefore generally not intended for long-term use in cases of frozen shoulder. Only use an immobilizing device if recommended by your doctor after surgery, a fracture, or another injury.
When Should You Wear a Shoulder Brace?
A shoulder brace can be worn temporarily during activities that place extra strain on the shoulder, such as work, walking, or light household tasks. It is generally not recommended to wear the brace all day. Alternate periods of support with gentle movement, and if in doubt, follow the advice of your doctor or physiotherapist.
When Should You See a Doctor?
Contact your doctor if your shoulder continues to become stiffer, if the pain disrupts your sleep, or if everyday activities become increasingly difficult. Medical evaluation is also important if you experience severe pain after a fall, sudden loss of strength, numbness, a visible deformity, or fever.
Your doctor can determine whether your symptoms are consistent with a frozen shoulder or whether another shoulder condition may be causing your complaints.