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Shoulder Treatment

Frozen Shoulder/Adhesive Capsulitis

Frozen Shoulder/Adhesive Capsulitis

Frozen Shoulder or as it is also known medically Adhesive Capsulitis

 is a common inflammatory condition that causes fibrosis of the shoulder joint capsule. It is accompanied by a progression in stiffness and limitation in movement causing ongoing restrictions in mobility and the ability to move your arm. This normally affects External Rotation ( arm rotating) flexion (arm forward) Abduction (arm to the side) and Hand up your back. It is most prevalent in females from the age of 40-59 yrs

What causes  Frozen Shoulder/Adhesive Capsulits?

Adhesive capsulitis often follows trauma or an injury to the shoulder that you may not even be aware of and if this occurs it can be classified as secondary disease capsulitis. After a trauma, there is an inflammatory process impacting the joint capsule that then causes restriction and increased stiffness. It is not known exactly why it occurs but it is thought that the inflammation is followed by reactive fibrosis and adhesions of the synovial lining of the joint.  A Primary disease Adhesive Capsulitis has a gradual onset with no trauma and is related to other conditions such as diabetes mellitus, thyroid disease, drugs, hypertriglyceridemia, or cervical spondylosis.

What are the 3 stages of Frozen Shoulder?

Frozen shoulder commonly passes through three stages/Phases:


  • 1. Painful/Freezing stage: During this stage Pain is the biggest problem that initially starts at night but then progresses to be painful at rest. There will be a slow increase of  limiting movement and can last from 2-9 months

  • 2. Frozen/ Adhesive stage: This period is characterized by progressive stiffness and reduced movement in all planes limiting normal function. Pain tends to reduce during this phase but stiffness is prevalent (lasts approximately 3-12 months

  • 3. Thawing/Regression stage: Range of movement improves and daily activities should become easier. Stiffness and pain should ease but there is a high chance of reoccurrence and full movement may not have returned (lasts approximately 12-24 months).

What Treatments can I do? 

Non-surgical treatments can include nonsteroidal anti-inflammatory drugs ( NSAIDS), short-term oral corticosteroids, corticosteroid injections, physiotherapy, acupuncture, and hydrodilatation. 


Physiotherapy and corticosteroid injections combined may provide greater improvement. This will involve an injection then an exercise programme to try and mobilise and stretch the shoulder. Injections have been shown to reduce pain, increase movement and improve function. 


Surgical treatment options for patients who have minimal improvement after conservative nonsurgical treatment include MUA (manipulation under anaesthesia) and arthroscopic capsule release. 

As Stuart is an Expert Shoulder Physio based in Edinburgh he is the ideal Physio to aid you in your Shoulder rehabilitation or help guide you to the right intervention.

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