Understanding Frozen Shoulder: Symptoms, Causes, and Effective Treatments

Frozen shoulder — formally known as adhesive capsulitis — is one of the most misunderstood shoulder conditions. The name suggests the joint somehow becomes stiff from inactivity or “freezing up,” but the real story is far more complex and rooted in inflammation, biology, and how your body responds to pain. The surprising truth? The original term was coined not because the shoulder was cold or frozen, but because patients in the early medical literature moved their arms as if they were “frozen in place.”

Today, we know much more. Frozen shoulder is a condition where the capsule surrounding your shoulder joint becomes inflamed, thickened, and tight, greatly limiting mobility and causing significant pain. Early recognition and the right treatment plan can dramatically reduce how long it affects you.

What Frozen Shoulder Really Is

Your shoulder joint is surrounded by a thin, flexible capsule that allows one of the widest ranges of motion in the human body. In adhesive capsulitis, that capsule becomes inflamed, then gradually thickens and contracts, creating adhesions — small bands of scar-like tissue — that restrict movement.

This process unfolds in three stages:

1. Freezing – Pain increases and mobility slowly worsens.

2. Frozen – Pain may improve but stiffness becomes severe.

3. Thawing – Gradual return of motion as inflammation resolves.

Left untreated, the full cycle can take 12–24 months.

Symptoms & Early Warning Signs

Early detection leads to better outcomes. Look for:

• Deep, aching shoulder pain (especially at night)

• Difficulty lifting the arm overhead

• Problems reaching behind the back

• Gradual stiffness, not linked to an injury

• Pain with simple tasks like putting on a jacket or fastening a seatbelt

If these symptoms show up without a clear injury, adhesive capsulitis should be on your radar.

Common Causes & Risk Factors

The exact cause isn’t always clear, but several conditions dramatically increase risk:

• Diabetes (up to 5x higher risk)

• Thyroid disorders

• Prolonged shoulder immobilization

• Autoimmune conditions

• Post-surgical inflammation

• Middle age (40–60 is the peak)

Women are also statistically more affected than men.

Treatment Options & Recovery Timelines

The good news: frozen shoulder almost always improves, and most people regain near-normal function.

Evidence-based treatment includes:

• Physical therapy to restore range of motion

• Anti-inflammatory medication

• Corticosteroid injections to reduce pain during the “freezing” stage

• Hydrodilatation (fluid injection to stretch the capsule)

• Home stretching routines done consistently

• Rarely: arthroscopic surgery for severe, non-responsive cases

With proper care, many recover in 6–12 months, instead of the typical 1–2 years.

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