What is Frozen Shoulder?

Leading orthopaedic surgeon Simon Moyes explains what “adhesive capsulitis”, also known as Frozen Shoulder and how best to treat it.

Frozen shoulder, also known as adhesive capsulitis, is characterised by the loss of movement in the shoulder joint and typically affects people over the age of 40.

It is a painful and disabling condition in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint, becomes inflamed and stiff, consequently resulting in chronic pain for the patient, with motion being severely restricted.

Pain is usually constant and is heightened during colder weather, making it virtually impossible to carry out even the simplest of day-to-day tasks. In more severe cases, patients may have difficulty sleeping as pain worsens at night. It is also known to cause neck and back pain, as well as depression.

What are the symptoms of frozen shoulder?

The symptoms of frozen shoulder usually develop across three natural stages. Initially, the patient will suffer from intractable pain in the shoulder joints. This will then be followed by the frozen stage, during which time the pain eases off and the stiffness becomes the main problem. The final stage will see the stiffness decrease and the patient notice a gradual increase in movement. This process can last for approximately 18 months in total.

During diagnosis, investigations will be carried out in order to rule out other pathologies. An MRI scan may be taken to show the glenohumeral joint effusion and thickening of ligaments. To begin with, the treatment process will focus on targeted pain relief, for which there are two options, oral analgesia or intra-articular hydrodilation injections. These are high-volume injections of local anaesthetic, saline and steroid into the shoulder joint. These are administered on two occasions a fortnight apart and followed up with physiotherapy. It works by stretching the shrunken joint capsule.

If the problem persists, then the need for surgery will be evaluated. Surgery is followed by a period of physiotherapy. The recovery period, however, is often very slow and often causes frustration for both patients and carers.

Simon Moyes is an internationally renowned orthopaedic surgeon. His Capital Orthopaedics team works at Basinghall Clinic in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals. Contact Simon Moyes for an expert diagnosis and treatment of shoulder injuries.