Frozen shoulder, also known as adhesive capsulitis, is a condition that can cause pain and stiffness in the shoulder. There is an increased incidence of frozen shoulder in people with diabetes – it is thought to affect 20 per cent of people with diabetes at some stage in their life, compared to just five per cent of people without diabetes. Frozen shoulder often develops after an injury to the shoulder, although sometimes there is no obvious case. Most commonly just one shoulder is affected, although sometimes both will be involved. The severity of the condition varies from person to person.
If someone doesn’t use their shoulder frequently, eg after an injury, scar tissue can form in the shoulder capsule (the thin tissue covering the shoulder joint). As a result the shoulder capsule tissue shortens and thickens, restricting the movement of the shoulder.
The progression of frozen shoulder is often described in three stages. The first stage is when the shoulder aches and feels stiff. The pain often gets worse during this period, which lasts anything from two to nine months, and the pain is often worse at night. The second stage is the ‘adhesive’ stage and can last from four to 12 months. The joint gets stiffer, although the pain may ease a little. As the shoulder is not usually used much during this stage, the muscles may begin to waste. The final stage is the recovery stage - the stiffness slowly goes away and movement increases, although there may still be some pain as you start to use your shoulder more.
Symptoms of frozen shoulder usually go and it is possible to get full use of your shoulder back, however this may take many months (between two and three years from onset on average).
The earlier frozen shoulder is recognised and treated the better. Physiotherapy and regular exercises can help keep the shoulder from stiffening up. Anti-inflammatory pain relief can also be helpful, as can muscle relaxants and local steroid injections to reduce inflammation. In severe cases surgery can be used to relieve symptoms and help restore freedom of movement in the shoulder.