Frozen Shoulder

Adhesive capsulitis (frozen shoulder):

• Common condition affecting 3 – 5% of the general population and 20% of the diabetic population.

• Often described as self-limiting; the majority of which resolve in 1-3 years although some patients will experience longer term movement deficit which lasts up to 10 years.

• A typical patient  would be  female in her 5th to 7th decade of life

• Rarely occurs simultaneously bilaterally although it can occur sequentially bilaterally.

• Normally classified as either primary: insidious onset of pain and progressive loss of movement at the shoulder or secondary; generally due to some form of trauma or subsequent immobilisation.

There are three distinct clinical phases:

• Freezing/painful stage; pain, worse at night decrease active and passive movement. Generally lasts for 3 – 9 months and is characterized by an acute synovitis of the glenohumeral joint

• The frozen/transitional stage. There is little change to the level of pain during this stage but range of movement loss can progress further. Lasts 4 – 12 months. A capsular pattern is therefore evident with most loss of external rotation followed by flexion/abduction and then internal rotation

• Thawing stage; starts when range of movement at the joint begins to improve. Generally lasts 12 – 42 months