Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder (FSS) is a syndrome, meaning it is defined by its signs and symptoms. Typically someone with a frozen shoulder will have pain and stiffness in the shoulder, but the diagnosis only applies to people whose movement is restricted passively. This means that when the shoulder is relaxed, movement is still limited when someone else is performing the movement.

There are other causes of lost passive movement in the shoulder, so your osteopath will rule these out before making a diagnosis. They may want you to see your GP to arrange an x-ray to rule out other conditions.

The name “adhesive capsulitis” means “sticky and inflamed capsule”, in reference to the joint capsule. The joint capsule is connective tissue that surrounds the joint. It is not entirely known what happens within the joint in frozen shoulder, but the current idea is a mix of inflammation within the joint, and a thickening of the joint capsule.

There are three phases in the cycle of frozen shoulder:

  1. Freezing phase
  2. Frozen phase
  3. Thawing phase

The duration of each stage varies a lot. Commonly quoted figures from start to finish range from 10 months to over 4 years. It appears (REF) that the process is sped up by interventions such as manual therapy, exercise, or injections??

Freezing

  • Movement becomes restricted
  • Pain is at its worst

Frozen

  • Movement is most restricted
  • Pain subsides

Thawing

  • Pain and lack of movement begin to resolve

What causes Frozen Shoulder?

There are two categories of frozen shoulder: primary and secondary. Primary FFS

Secondary FSS follows a significant event such as an injury or immobilisation, or coincides with another condition such as diabetes or high blood pressure. People with diabetes are twice as likely to develop FSS than people who do not have diabetes. It is not uncommon for the other shoulder to freeze a few months after the first resolves.

Medscape, diabetes.co.uk,

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