Frozen shoulder, also known as adhesive capsulitis, is an unpleasant medical condition. Frozen shoulder is characterized by severe daytime and night-time pain, as well as restricted movement in the shoulder joint. The cause is an inflammatory thickening of the joint capsule due to the connective tissue, followed by capsular shrinkage.
Frozen shoulder is one of the most common shoulder diseases. It occurs mainly between the ages of 40 and 70. Women are affected slightly more often than men. Often it is unclear why the frozen shoulder developed. However, there are also secondary forms of frozen shoulder that develop as a result of other shoulder problems, after an accident, or in metabolic diseases such as diabetes mellitus or hypothyroidism.
Frozen shoulder is nearly always a self-limiting condition. The natural course is 12 to 48 months before healing occurs.
The cause of frozen shoulder is still unclear. It can be assumed that a complex cascade of inflammatory processes leads to thickening and shrinking of the joint capsule. This condition is called adhesive capsulitis and is accompanied by severe pain.
A gradual onset is typical. In the first inflammatory phase, the focus is on constant pain. In the 2nd freezing phase, which begins weeks to months later, movement restrictions develop as well. Lifting the arm and external rotation are particularly restricted. In the 3rd thawing phase, the mobility of the shoulder joint slowly returns.
The diagnosis of 'frozen shoulder' can be established through a medical consultation and careful examination. The main symptom is a reduced and terminally painful passive external rotation in the adduction of the upper arm.
During the inflammation phase, the emphasis is on reducing inflammation:
- Anti-inflammatory drugs (NSAID -> Ponstan, Voltaren, ...)
- Interventional treatments:
- Ultrasound-guided blockade of the N. suprascapularis
- Cortisone injection into the shoulder joint
- Rest: physiotherapy only for concomitant problems such as stiff neck, rest the shoulder!
During the freezing and thawing phase:
- Additional cautious physiotherapy to improve the mobility of the shoulder joint.
- Favejee M., Frozen shoulder: the effectiveness of conservative and surgical interventions--systematic review., Br J Sports Med. 2011 Jan;45(1):49-56