Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, is a frustrating and often painful condition that limits the movement of the shoulder joint. While the exact cause isn’t always clear, the good news is that frozen shoulder typically improves over time with the right approach. At our clinic, we understand how challenging this condition can be and are here to guide you through every stage of recovery with evidence-based treatments designed to relieve pain, restore mobility, and help you get back to doing the things you enjoy.

Frozen shoulder often develops in three distinct stages:

Freezing Stage (6 weeks to 9 months):

• Gradual onset of pain, especially at night.
• Increasing stiffness, making movement difficult.

Frozen Stage (4 to 12 months):

• Pain may decrease, but stiffness worsens.
• Range of motion becomes significantly restricted.

Thawing Stage (6 months to 2 years):

• Gradual improvement in mobility and reduction in stiffness.

The exact cause of frozen shoulder isn’t always clear, but it’s associated with:

• Injury or Surgery: Shoulder immobilization after an injury or surgery increases risk.
• Medical Conditions: Diabetes, thyroid disorders, or cardiovascular disease can predispose individuals.
• Age and Gender: Common in people aged 40–60, particularly women.

Frozen shoulder can be managed through a combination of treatments. Physiotherapy is central to managing frozen shoulder, focusing on pain relief and improving mobility.

• Manual Therapy: Gentle techniques to mobilize the joint and reduce stiffness.
• Exercise Therapy: Specific stretching and strengthening exercises to improve range of motion and function.
• Electrotherapy: Modalities like ultrasound or TENS to reduce pain and inflammation.
• Education and Self-Management: Guidance on activity modification, posture, and home exercises.

Research shows that physiotherapy can accelerate recovery, especially when combined with other interventions.

Cortisone Injections
Corticosteroid injections may be recommended during the early stages of frozen shoulder to reduce inflammation and alleviate pain. This can allow individuals to engage more effectively in physiotherapy.

Hydrodilatation (Hydrodistension)
Hydrodilatation involves injecting a sterile solution (saline, local anesthetic, and sometimes a corticosteroid) into the shoulder joint under imaging guidance. This helps stretch the joint capsule and improve mobility. Studies have shown that this minimally invasive procedure can provide significant pain relief and restore movement.

Yes, but it can take time! Frozen shoulder can take up to two years to resolve completely, but early intervention can make a significant difference. Physiotherapy, combined with other treatments like cortisone injections or hydrodilatation, often leads to faster recovery and improved outcomes.

At our clinic, we offer a comprehensive approach to frozen shoulder, combining evidence-based physiotherapy techniques with guidance on other medical interventions such as cortisone injections or hydrodilatation. Our goal is to help you regain pain-free movement and get back to doing the things you love.

• Bridgman, J. (2020). Physiotherapy management of adhesive capsulitis: A systematic review. Journal of Physiotherapy, 66(1), 1-12.
• Carette, S., et al. (2003). Injection of corticosteroids versus physiotherapy for adhesive capsulitis of the shoulder. The New England Journal of Medicine, 348(9), 791-798.
• Buchbinder, R., et al. (2017). Hydrodilatation for frozen shoulder: A systematic review and meta-analysis. British Journal of Sports Medicine, 51(18), 1423-1430.