Frozen Shoulder

What is a frozen shoulder? What are the symptoms of frozen shoulder?

What are the causes of frozen shoulder?

What conservative treatment is available for frozen shoulder?

When should frozen shoulder surgery be performed?

What is a frozen shoulder? What are the symptoms of frozen shoulder?

A severe limitation of shoulder joint mobility, with or without pain: this condition is known as frozen shoulder.

Frozen shoulder (adhesive capsulitis) is a degenerative process of the shoulder joint in which the joint capsule is subject to pathologically increased tissue remodeling and shrinkage.
A distinction is made between primary and secondary frozen shoulder.

Symptoms of a primary frozen shoulder

A primary frozen shoulder can be divided into three stages, which are characterized by different symptoms:

• Stage I (freezing, inflammatory phase): A gradual onset with gradually increasing shoulder pain is typical. The pain is particularly severe at night and sleeping on the affected side is no longer possible. A restriction of movement (stiffness) gradually develops. Rotation is particularly affected, for example “gripping the back”.
• Stage II (frozen, stiffening phase): The pain in the shoulder joint slowly subsides, but mobility is increasingly restricted. Movements in which the arms spread away from the body or turn outwards in the shoulder joint cause particular pain. The restriction of the joint is most noticeable in this phase.
• Stage III (thawing, thawing phase): Shoulder mobility improves again after 6 to 18 months. The shoulder “thaws”. In many cases, those affected can move their shoulder again, but minor discomfort always remains.

Symptoms of a secondary frozen shoulder

Secondary frozen shoulder typically occurs after an injury or an operation. Wear-related diseases of the shoulder can also lead to frozen shoulder. In the case of secondary frozen shoulder, phases in the course of the disease are less clearly recognizable and also more difficult to treat.

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What causes frozen shoulder?

The term “idiopathic form” refers to the stiffening of the shoulder without any recognizable external cause. The typical patient is female and between 40 and 60 years old. The causes of primary frozen shoulder are not known. There can be various causes of secondary frozen shoulder. These include shoulder injuries such as rotator cuff tears or fractures and contusions of the shoulder joint. However, operations can also lead to frozen shoulder. Some specific diseases, such as diabetes mellitus or thyroid disorders, increase the risk of developing frozen shoulder.

What conservative treatment is available for frozen shoulder?

In principle, there are various pillars of conservative treatment for frozen shoulder:

• Physiotherapy and self-exercises to stretch the capsule
• Injection treatments (injections into the shoulder joint)
• Cortisone therapy (tablets)
• Anti-inflammatory medication

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When should frozen shoulder surgery be performed?

Surgery can usually be avoided in the case of primary frozen shoulder. If conservative treatment of frozen shoulder does not bring any improvement or the underlying shoulder disease needs to be treated, surgery is advisable. This involves removing the adhesions and shortening of the joint capsule. This procedure is performed using minimally invasive arthroscopy (keyhole surgery). Frozen shoulder surgery not only treats the frozen shoulder but also the underlying cause.
However, the right time is always important - the painful part of the disease must be waited for.