Frozen shoulder occurs when the shoulder joint capsule becomes tight and inflamed, leading to pain and stiffness. It commonly develops due to prolonged shoulder immobility after injury or surgery. The risk is higher in people recovering from a stroke, those who have had breast or shoulder surgery, and individuals with diabetes or hormonal changes, especially women between 40 and 60 years of age.
Frozen Shoulder Physiotherapy in Bengaluru
The frozen shoulder, also known as adhesive capsulitis, is a major cause of shoulder pain and restricted movement. It commonly affects individuals between 40 and 60 years of age and is seen more frequently in women. For effective and long-lasting results, it is important to undergo proper physiotherapy. At Bone & Joint Physio, Bengaluru, Dr. Kiran provides specialised physiotherapy treatment for frozen shoulder using a personalised and evidence-based approach.
Often confused with a rotator cuff injury, frozen shoulder usually begins with severe shoulder pain that gradually progresses to stiffness and reduced mobility. The risk of developing this condition increases in individuals recovering from a stroke or mastectomy, or those with prolonged shoulder immobility. Treatment mainly involves range-of-motion exercises and structured physiotherapy programs. Medications may be prescribed to manage pain, and in rare cases where conservative treatment fails, arthroscopic surgery may be recommended.
Causes of Frozen Shoulder
Facts about Frozen Shoulder
Frozen shoulder causes thickening and tightening of the shoulder joint capsule, reducing its normal flexibility and leading to gradual pain and stiffness in the shoulder.
Shoulder capsule, the soft tissue around your shoulder joint plays a key role in keeping the humerus within the shoulder socket. Thus, changes in the capsule results in its abnormal function.
Symptoms of Frozen Shoulder
The frozen shoulder develops in three stages. Confusingly, each stage has different symptoms. Its stages are:
Stage 1 – Freezing Stage
This stage begins with gradual shoulder pain, especially during movement and at night. As pain increases, shoulder movement starts to become limited.
Stage 2 – Frozen Stage
Pain may reduce slightly, but stiffness increases significantly. Shoulder movement becomes very restricted, making daily activities difficult.
Stage 3 – Thawing Stage
In this final stage, shoulder mobility slowly improves. Pain reduces further, and range of motion gradually returns with proper physiotherapy.
During the third stage, shoulder movement gradually improves, and this phase may last from 15 months to over 2 years. It is also referred to as the thawing or white phase, as the shoulder capsule appears pale or white during arthroscopic examination due to reduced inflammation.
Diagnosis of Frozen Shoulder
Frozen shoulder can be diagnosed by a qualified medical professional through a thorough physical examination. The physiotherapist will ask about your symptoms and the difficulties you face during daily activities, such as lifting the arm, reaching overhead, sleeping on the affected side, or performing routine movements.
Detailed Physical Examination
After reviewing your medical history and symptoms, the physiotherapist will assess your shoulder by asking you to perform specific movements. The shoulder may also be gently moved in different directions to evaluate the range of motion. Both active movements (performed by you) and passive movements (performed by the therapist) are compared to identify stiffness and movement restriction.
Additional Tests to Confirm Frozen Shoulder
Since shoulder pain and stiffness can occur due to other conditions, imaging tests such as X-ray, ultrasound, or MRI may be recommended. These tests help rule out other issues like rotator cuff injuries, arthritis, or fractures and confirm the diagnosis of frozen shoulder.
During the third stage, shoulder movement gradually improves, and this phase may last from 15 months to over 2 years. It is also referred to as the thawing or white phase, as the shoulder capsule appears pale or white during arthroscopic examination due to reduced inflammation.
Frozen Shoulder Treatment
Recovery from frozen shoulder is gradual and may take up to 2–3 years for complete healing. The treatment approach depends on the stage of your frozen shoulder, and therapy is customised accordingly.
1. Freezing Stage
During this initial phase, pain management is the primary focus. This may include prescribed pain-relief medications. If pain persists or becomes severe, intracapsular corticosteroid injections may be considered. Additional treatments like dry needling, acupuncture, and kinesiology taping are often used to reduce pain and muscle tension during this stage.
2. Frozen Stage
In this stage, the shoulder becomes stiff, and the focus shifts to gentle stretching and muscle release techniques. Mobilization with movement (MWM) is an effective physiotherapy technique during this phase. Care is taken to avoid aggressive exercises, as they can worsen the condition. In some cases, hydrodilation is used to assist stretches and reduce adhesions or capsular scarring.
3. Thawing Stage
The final phase, thawing, is when significant improvement is usually observed. Physiotherapist-guided mobilizations and progressive exercises help restore shoulder mobility and strength. Strengthening exercises are introduced gradually to support long-term recovery. Physiotherapy is particularly effective during this stage and ensures a safe and complete return to normal shoulder function.
During the third stage, shoulder movement gradually improves, and this phase may last from 15 months to over 2 years. It is also referred to as the thawing or white phase, as the shoulder capsule appears pale or white during arthroscopic examination due to reduced inflammation.
Need for Surgery
Surgery is rarely needed for frozen shoulder. It is considered only in severe cases when physiotherapy and medications fail to provide relief. Even after surgery, physiotherapy is essential for restoring movement and strength.
How to Prevent Frozen Shoulder?
Prevent frozen shoulder by keeping the shoulder active and mobile, avoiding prolonged immobility, and doing regular gentle stretching exercises. Early physiotherapy and good posture also help reduce the risk.