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Frozen shoulder

This factsheet is for people who have frozen shoulder, or who would like information about it.

Frozen shoulder (adhesive capsulitis) is a condition that causes pain and stiffness in your shoulder, eventually making your shoulder difficult to move. 

Your shoulder joint (also known as the glenohumeral joint) is a ball and socket joint. Normally, the ball at the end of your upper arm bone (humerus) moves smoothly in the shallow socket on the edge of your shoulder blade (scapula). Strong connective tissue, called the capsule, surrounds the joint.

Frozen shoulder is a condition that occurs as a result of inflammation (soreness and swelling) around your shoulder joint and its surrounding capsule. You’re more likely to get frozen shoulder if you’re aged between 40 and 60. It’s also more common among women than men.

There are three stages of frozen shoulder.

  • Freezing. During this stage you will slowly develop pain that gets worse as you lose motion in your shoulder. This stage can last between six weeks and nine months.
  • Frozen. The pain may have settled during this stage but your shoulder will remain stiff. This can last between four and six months.
  • Thawing. During this final recovery stage you will begin to get movement back in your shoulder. This stage can last between six months and two years.
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Details

  • Symptoms Symptoms of frozen shoulder

    Symptoms of frozen shoulder include:

    • a dull or aching pain in your affected shoulder
    • stiffness around your shoulder joint
    • restricted range of movement in your affected shoulder

    The stiffness may make it difficult for you to do everyday tasks, such as driving, dressing or sleeping. You may also have difficulty scratching your back or putting your hand in your back pocket. The pain usually comes on gradually, and is often worse when you move your shoulder joint. It may also be worse at night.

    These symptoms may be caused by problems other than frozen shoulder. If you have any of these symptoms, see your GP for advice.

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  • Diagnosis Diagnosis of frozen shoulder

    If you think you have frozen shoulder, see your GP.

    Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

    Your GP may refer you for one or more of the following tests.

    • X-ray. This uses radiation to produce an image of the inside of your shoulder.
    • MRI scan. This uses magnets and radiowaves to produce images of the inside of your shoulder.
    • Ultrasound. This uses sound waves to produce an image of the inside of your shoulder.

    These tests can rule out other causes of your shoulder stiffness and pain, such as rotator cuff injury or osteoarthritis.

  • Treatment Treatment of frozen shoulder

    Frozen shoulder will usually get better on its own. However, it can sometimes take years to completely go away. Treatment for frozen shoulder depends on the stage of your condition.

    Self-help

    If you need pain relief during the first stage of frozen shoulder, you can take over-the-counter painkillers, such as paracetamol, or non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    During the early, freezing stage, your GP may advise you not to move your shoulder in any way that causes you pain, for example, overhead lifting or vigorous stretching. It’s important, however, to continue moving your shoulder regularly during day-to-day activities and not to stop moving your shoulder completely.

    Around nine out of 10 people find that the pain gets better and the movement improves after following these self-help treatments.

    Physiotherapy

    Your GP may refer you to a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility), who will show you suitable exercises to help stretch your shoulder muscles and improve the strength and movement of your shoulder. See our frequently asked questions for more information about exercises.

    If your frozen shoulder is severe or if it isn’t getting better after trying other types of treatment, your GP may give you a steroid joint injection.

    Surgery

    You may need to have surgery if other types of treatment haven't been helpful. The following are the most common surgical methods.

    • Shoulder manipulation. Your surgeon will move your shoulder around, while you are under general anaesthesia. This means that you will be asleep during the procedure.
    • Shoulder arthroscopy. A type of keyhole surgery, which can be used to look inside and treat your shoulder joint. This is usually done under local anaesthesia. This completely blocks pain from your shoulder area and you will stay awake during the procedure. However, sometimes you will be under general anaesthesia because it can be uncomfortable for some people to stay in one position for the length of time needed to complete the procedure.

    Sometimes both of these procedures are done at the same time. Most people who have surgery will have good results. If you have surgery, you will need to have physiotherapy to maintain the motion in your shoulder. It can take between six weeks and three months for you to recover.

  • Frozen shoulder treatment on demand

    You can access a range of our health and wellbeing services on a pay-as-you-go basis, including frozen shoulder treatment.

  • Causes Causes of frozen shoulder

    The exact reason why frozen shoulder develops is not known at present. It’s thought to be caused by inflammation of your shoulder joint and its surrounding capsule. Frozen shoulder can sometimes develop if you have had a shoulder injury, such as a fracture, or if you have had surgery on your shoulder.

    Some medical conditions can increase your risk of getting frozen shoulder, including:

    • diabetes
    • hypothyroidism and hyperthyroidism
    • Parkinson's disease
    • cardiovascular disease

    Frozen shoulder is estimated to affect two in 10 people with diabetes at some point in their life. 

  • Prevention Prevention of frozen shoulder

    The best way to prevent frozen shoulder is to get treatment as early as possible if you injure your shoulder or develop shoulder pain that limits your range of movement.

  • FAQs FAQs

    Can I use acupuncture for my frozen shoulder?

    Answer

    At the moment there isn't enough evidence to say whether acupuncture is beneficial for frozen shoulder or not.

    Explanation

    Acupuncture typically involves puncturing your skin with fine needles, at defined points, to relieve symptoms of certain conditions, such as pain.

    There have only been a small number of studies investigating whether acupuncture is an effective way to treat frozen shoulder. In these studies, the improvements for pain and movement were the same for people who had acupuncture compared to those who received dummy treatment (placebo) for two to four weeks. The evidence isn't clear and therefore more studies are needed to test the effectiveness of acupuncture in treating frozen shoulder.

    If you have frozen shoulder, it's important that you keep your shoulder joint moving. Stretching and gentle exercises can be helpful to restore range of movement. It may take several years for your symptoms to improve and you may need to visit a physiotherapist for treatment.

    If you do decide to have acupuncture, check that your therapist belongs to a recognised professional body.

    If I have frozen shoulder and my job involves heavy manual labour, do I need to take time off work?

    Answer

    If you have frozen shoulder, you don't usually need to take time off work. However, this can depend on the stage of your frozen shoulder, the nature of the work you do and whether you can do other activities that don't involve heavy, manual labour.

    Explanation

    In the early stage of frozen shoulder, you shouldn't do any activity or exercise that causes pain, such as overhead lifting, or any movement that causes your shoulder to stretch excessively. You should use your pain as a guide to which activities you can do. It's important that you keep your joint moving so try to continue using your shoulder for normal day-to-day activities if possible. Taking over-the-counter painkillers, such as paracetamol or non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help during the early stage. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    When your pain has improved, you can do gentle exercise and stretching to help improve the range of movement of your shoulder joint. Your GP may refer you to a physiotherapist who will show you some exercises. If your pain is severe or treatment doesn't help, your GP may refer you to an orthopaedic surgeon (a doctor who specialises in bone surgery).

    Speak to your GP if your shoulder pain is affecting your work.

    What exercises can I do for frozen shoulder?

    Answer

    If you have frozen shoulder, you should keep your shoulder moving as much as possible without aggravating the pain too much. There are a number of exercises and stretches you can do to improve the stiffness and range of movement in your shoulder joint.

    Explanation

    Regular, gentle exercise and stretching is important for your shoulder joint if you have frozen shoulder. This helps to prevent your muscles wasting and can also help improve any stiffness. It's important that you don't do any movement that causes pain, such as lifting objects above your head or vigorous stretching.

    The following exercises may help your frozen shoulder.

    • Stand in a doorway and hold on to the doorframe with your injured arm bent at 90 degrees. Rotate your body away from the doorway until you feel a gentle stretch.
    • Lie on your back with your legs straight and flat on the floor. Use your unaffected arm to raise your injured arm overhead until you feel a gentle stretch.
    • Gently pull your injured arm across your chest just below your chin as far as possible without causing pain.

    Your GP can refer you to a physiotherapist. A physiotherapist can show you exercises and stretches that will help to restore the range of movement in your shoulder.

  • Resources Resources

    Further information

    Sources

    • Frozen shoulder. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org, published January 2011
    • Brukner P, Khan K. Clinical Sports Medicine. 3rd ed: McGraw Hill, 2006:243–5
    • Frozen shoulder. PubMed Health. www.ncbi.nlm.nih.gov/pubmedhealth, published 31 October 2010
    • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford Medical Publications, 2005:552–3
    • Frozen shoulder. Diabetes UK. www.diabetes.org.uk, accessed 7 March 2012
    • Shoulder pain. Prodigy. www.prodigy.clarity.co.uk, published November 2008
    • Shoulder arthroscopy. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org, published April 2011
    • Green S, Buchbinder R, Hetrick SE. Acupuncture for shoulder pain (review). The Cochrane Collaboration 2008, issue 4. doi:10.1002/14651858.CD005319
    • The statutory regulation of the acupuncture profession. Department of Health. www.dh.gov.uk, published September 2003
  • Related information Related information

  • Author information Author information

    Produced by Dylan Merkett, Bupa Health Information Team, July 2012. 

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