What is a frozen shoulder?

Frozen shoulder is the term used to describe a condition where the shoulder joint capsule becomes thickened and contracts (shrinks). When the capsule shrinks the glenohumeral joint does not move as easily and gradually more and more motion is lost until the shoulder becomes "frozen" and does not move any more.

There are varying degrees of frozen shoulder. Sometimes there is a mild restriction of motion and sometimes the shoulder is so frozen that there is very little motion of the shoulder at all.

What causes frozen shoulder?

A number of conditions can cause frozen shoulder. One of the most common causes is immobilizing the shoulder after injury or because of another painful shoulder problem such as bursitis or tendonitis. There are many conditions that have been linked to frozen shoulder. Some of these conditions are listed below:

- Rotator cuff tears
- Osteoarthritis of the shoulder joint or the acromioclavicular joint
- Diabetes
- Thyroid problems
- Heart attacks
- Fractures (broken bones) of the upper arm 
- Certain cancers 

What does a frozen shoulder feel like?

Frozen shoulder can be divided into three different phases or periods.

a) The painful period - This period can last anywhere from six weeks to eight months. Towards the end of this period shoulder pain usually decreases.

b) The frozen or stiff period - This period can last anywhere from six weeks to one year. There is often minimal pain during this period. The most bothersome thing in this period is the lack of shoulder range of motion. During this period shoulder range of motion does not change.

c) The recovery period - This period can last anywhere from six months to two years. During the recovery period there is a gradual increase in shoulder range of motion. Usually there is full recovery of shoulder range of motion. Unfortunately, sometimes the last degrees of range of motion do not come back.

What is the treatment for a frozen shoulder?

A lot can be done to help people who have frozen shoulder. Most times, treatment will begin with a conservative approach. The following conservative treatments should be tried and continued according to how much pain relief or improvement in shoulder function they produce:

- A program of stretching and strengthening exercises.
- Ice therapy.
- Anti-inflammatory or pain medications.
- Active release therapy.
- Cortisone injections.
- Acupuncture

Doctors and physical therapists (physiotherapy) who deal with people who have frozen shoulders can help outline a conservative treatment program.

If the conservative approach to managing a frozen shoulder is not effective, surgery may be required. An orthopaedic surgeon may perform arthroscopic surgery or they may move the shoulder through its full range while the patient is under an anaesthetic thus breaking up scar tissue and loosening the joint capsule.