Frozen Shoulder: Causes and Stages of Freezing

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Frozen Shoulder or Adhesive Capsulitis is a condition whereby the shoulder joint becomes stiff and painful to move in all directions. It usually develops gradually, worsens over time, then eventually resolves; this usually occurs over a 2 year period.

Therefore, frozen shoulder affects mainly people between the ages of 40 and 60 years old, it can occur in either shoulder and in men or women.


What causes Frozen Shoulder?

The shoulder is a ball and socket joint that allows it to move in more directions than any other joint in the body. There is a capsule around the joint that is made up of soft tissue fibres. In a frozen shoulder, this capsule becomes contracted and forms bands of scar tissue called adhesions.

This causes stiffness and often severe pain in the shoulder joint.

There are certain things that make people more at risk of developing a frozen shoulder, including:

  • Age – it is more common in people of ages 40 – 60 years old
  • Gender – about 70% of people who get frozen shoulder are women
  • Diabetes – people with diabetes are more likely to develop the condition and it also takes longer to recover
  • Immobility – not moving a shoulder often enough after an injury can turn into a frozen shoulder
  • Systemic diseases – tuberculosis, thyroid issues, Parkinson’s disease and cardiovascular disease puts people more at risk

What does Frozen Shoulder feel like?

In brief, the frozen shoulder usually comes on gradually over time. Additionally, it is usually associated with pain, stiffness and limitation in shoulder movement. Your strength is not usually affected.

Common symptoms include:

  • Dull or aching pain; sometimes sharp with movement
  • Pain in the outer region of the shoulder that can radiate into the outer upper arm
  • Discomfort that’s worse at night and in cold environments
  • Inability to sleep on the affected shoulder
  • Stiffness in the shoulder that worsens over time

There are typically 3 phases in frozen shoulder which occur over a period of up to 2 years.

Phase 1 – Freezing phase

Firstly, the shoulder gradually becomes more painful over a period of time. With pain, the shoulder starts becoming stiffer.

Phase 2 – Frozen phase

Secondly, the shoulder pain improves a little during this phase. However, shoulder movement will be extremely limited and performing daily tasks such as dressing or grooming will be painful and difficult.

Phase 3 – Thawing phase

Lastely, the shoulder pain will gradually alleviate and diminish during this phase. It will also be easier to move the shoulder as the stiffness improves while your shoulder is “thawing”. (How do you thaw a frozen shoulder?)

Experiencing shoulder pain? Click here to find out more about physiotherapy for shoulder pain relief and how Core Concepts can help.