Scientifically known as adhesive capsulitis, a frozen shoulder is a slow progressing condition that causes pain and stiffness in the shoulder, greatly limiting its range of motion. The shoulder joint which consists of the humeral head and the glenoid (also known as the ball and socket), gradually loses its mobility over three stages:
Stage 1, Freezing: large amount of pain but range of motion is unhindered. Lasts approximately 2 to 9 months.
Stage 2, Frozen: pain is reduced but range of motion is limited. Lasts approximately 4 to 12 months.
Stage 3, Thawing: absence of pain and range of motion is gradually restored. Lasts approximately 5 to 24 months.
Frozen shoulder causes pain and limited range of motion.
What causes frozen shoulder?
Most of the time, a frozen shoulder occurs when the connective tissues and muscles that make up the shoulder joint get inflamed and irritated, causing them to thicken and tighten. However, for some individuals, there is sometimes no discerning cause of a frozen shoulder.
There are two types of frozen shoulder categorised based on their causes, these are:
Primary frozen shoulder: cause is unknown.
Secondary frozen shoulder: caused by injury or trauma that results in structural changes to the shoulder or neighbouring tissues.
Most of the time, frozen shoulders are caused by inflamed connective tissues that thicken and tighten, resulting in stiffness and pain.
What are the symptoms of frozen shoulder?
The symptoms of a frozen shoulder are dependent on its stage, but general symptoms are:
Reduced range of motion that affects daily activities such as putting on clothes, combing hair, etc.
Dull ache or sharp pain in the outer shoulder or upper arm, which may worsen at night.
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
Frozen shoulder is often characterised by a dull ache or sharp pain, depending on the stage.
It is usually more painful in the early stages of the condition, with the pain lessening as the stages progress.
Who is at risk of frozen shoulder in Singapore?
There are various factors that may increase your risk of developing frozen shoulder, these are:
Age: adults over the age of 40 are more likely to develop frozen shoulders.
Gender: women are more likely to develop frozen shoulders than men.
Immobility: frozen shoulder can be caused by the immobilisation of the shoulder for a long period of time. Recovery from surgery, injury, or a broken arm, requires your shoulder to remain still, this can increase your risk of developing a frozen shoulder.
Medical conditions: some medical conditions such as diabetes, hyperthyroidism, hypothyroidism, Parkinson’s disease, and cardiovascular disease can increase your risk of developing a frozen shoulder.
Frozen shoulders are more likely to affect females as they age.
How is frozen shoulder diagnosed?
Diagnosis of a frozen shoulder involves the following:
Physical examination: your active (you move your own arm) and passive (your arm will be moved for you) range of motion will be observed. Individuals with a frozen shoulder will have difficulty with both active and passive movement.
X-rays: an x-ray will be taken of your shoulder to check for other causes of your pain.
Magnetic resonance imaging (MRI)/ultrasound:MRI and ultrasounds may be required to rule out other causes of your pain such as rotator cuff injury.
What are the treatment options for frozen shoulder in Singapore?
Treatment for a frozen shoulder are as follows:
Medication: painkillers are prescribed to relieve pain and reduce swelling.
Physiotherapy:physiotherapy involves the use of gentle and therapeutic exercises that help to improve your range of motion and increase your muscle strength.
Corticosteroid injections:corticosteroid injections are quick solutions that help to reduce inflammation.
Arthroscopic surgery: minimally invasive arthroscopic surgery will be used to cut tight parts of your shoulder joint to release the tension.
The first line of treatment is usually non-invasive options such as medication (oral and injections) or physiotherapy. These treatments are conducted over a year and surgery is only considered after these options have failed.
Frequently asked questions
What is frozen shoulder called?
Does frozen shoulder go away on its own?
What are the first signs of a frozen shoulder?
our process
Feeling aches and pains?
Book a consultation with us for a more comprehensive diagnosis and a personalised treatment plan best suited to your needs.
