Frozen Shoulder (Adhesive Capsulitis) - Treatment in Adelaide
Dr Arthur Turow, Shoulder SurgeonFrozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain, stiffness, and reduced range of motion in the shoulder joint. It starts gradually and frequently persists for many months. Dr Arthur Turow is an Adelaide based orthopaedic surgeon specialising in shoulder and upper limb conditions. He offers expert diagnosis, evidence-based treatment guidance and advanced surgical options, including arthroscopic capsular release, delivering best practice care to patients with shoulder stiffness from frozen shoulder.
What is Frozen Shoulder (adhesive capsulitis)?
Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain, stiffness, and reduced range of motion in the shoulder joint. It typically develops gradually over time and progresses through three distinct phases: freezing, frozen, and thawing.
The exact cause of frozen shoulder is not fully understood, but it is thought to occur due to the thickening and tightening of the capsule surrounding the shoulder joint. This can lead to the formation of adhesions or scar tissue, which restricts movement and causes pain.
What are the risk factors for frozen shoulder?
The most common risk factors associated with developing frozen shoulder include:
Age and gender
It most commonly affects people between the ages of 40 and 60, and women are more prone to developing frozen shoulder than men.
Immobilisation or reduced shoulder movement
Shoulder injury, surgery, or conditions that limit shoulder movement (such as a rotator cuff tear) can contribute to the development of frozen shoulder.
Systemic conditions
Certain medical conditions, such as diabetes, cardiovascular disease, thyroid disorders, and autoimmune conditions, have been associated with an increased risk of frozen shoulder.
What are the stages of frozen shoulder?
Frozen shoulder usually goes through three stages during the natural course of the condition with varying symptoms. Each stage can last between 3-6 months:
Freezing Phase
The freezing phase is characterised by the onset of shoulder pain and gradually increasing stiffness. During this phase, the shoulder becomes progressively more painful, making everyday activities and movements challenging. The pain may be more pronounced at night, disturbing sleep. Shoulder range of motion starts to decrease, particularly with movements such as reaching overhead, reaching behind the back, or across the body. This phase can last several weeks to several months.
Frozen Phase
Once the freezing phase subsides, the frozen phase begins. In this stage, pain may reduce or become localised to specific movements or positions. However, the shoulder stiffness and limited range of motion persist. The shoulder joint becomes significantly restricted, making it difficult to perform daily tasks and activities. This phase can last for several months to a year or more.
Thawing Phase
The thawing phase is the final stage of frozen shoulder. During this phase, the shoulder gradually regains its range of motion and function. The pain lessens , and the stiffness begins to loosen. Shoulder movements become easier, and individuals experience an improvement in their ability to perform activities that were previously difficult or impossible. The duration of the thawing phase varies among individuals and can last several months to years.
Normal Shoulder
In a normal shoulder, the joint capsule (arrow) is large enough to allow full range of motion.
Frozen Shoulder
In a frozen shoulder, the joint space (arrow) is tightened, leading to joint pain and stiffness.
Treatment Options
Non-surgical Management
Treatment for frozen shoulder focuses on relieving pain, restoring range of motion, and improving shoulder function. It typically involves a combination of:
Pain management
Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to reduce pain and inflammation.
Physical therapy
Gentle stretching exercises, range of motion exercises, and shoulder-specific exercises to improve flexibility, strength and maintain good shoulder health.
Heat or cold therapy
Applying heat or cold packs to the shoulder may help alleviate your pain and improve mobility.
Manual therapy
Manual therapy is aimed at mobilising the muscles around your shoulder and help alleviate tension and help with symptoms of a stiff shoulder. This may provide pain relief and a sense of increased shoulder mobility.
Surgical Frozen Shoulder Release
In cases where non-operative treatment has not been effective or you have noticed that your shoulder has not progressed in function, surgery may be needed. Minimally invasive surgery and manipulation under anaesthesia are used to release your shoulder and improve range of motion. This is usually done with shoulder arthroscopy where a specialised camera (arthroscope) is used to assess and release the tight capsule to improve your shoulder range of motion.
Shoulder Arthroscopy
Why Choose Dr Arthur Turow for Frozen Shoulder Surgery in Adelaide
When it comes to your shoulder treatment, choosing an experienced and trusted specialist is essential. Dr. Arthur Turow is an Australian-trained orthopedic surgeon providing a high level of expertise in diagnosing and treating complex shoulder conditions.
- Shoulder Specialist: Subspecialty training in shoulder and upper limb surgery
- Advanced Techniques: Arthroscopic surgery tailored to each patient
- Local Expertise: Accessible care across Adelaide and South Australia, including Yorke Peninsula, Gawler and Mt Barker
- Patient-Centred Care: Personalised treatment tailored for every patient
- Recognised Training: Fellow of the Royal Australasian College of Surgeons (FRACS) with additional memberships of the Australian Orthopaedic Association (AOA) and Australian Medical Association (AMA)
What to expect after frozen shoulder surgery?
During frozen shoulder surgery, specialised arthroscopic instruments are used to release the tight shoulder capsule. After surgery, you will be encouraged to commence early range of motion to maintain your shoulder mobility. Our physiotherapy team will guide you through the first stages of recovery. An approximate timeline of your recovery is outlined below:
Stage 1 – Early stretches and range of motion
- You will be encouraged to start early range of motion while still in hospital
- You will be provided with a schedule for passive stretches and active range of motion
- Regular, early physiotherapy is important to maintain your shoulder mobility
Stage 2 – Maintain Range of Motion & Strengthening
- It is encouraged to wean out of the sling over 1 week
- Resistance training and range of motion is increased
- The aim is to maintain your shoulder mobility through shoulder specific exercises
Frequently Asked Questions
What causes frozen shoulder?
Frozen shoulder can develop after an injury, after surgery or from systemic conditions such as diabetes. It involves inflammation of the shoulder capsule leading to pain and stiffness.
How long is the recovery for frozen shoulder?
Frozen shoulder usually takes 9-18 months. Most patients start to notice improved pain and increasing range of motion within 6-12 months.
How is frozen shoulder treated?
Treatment of frozen shoulder focuses on relieving pain, restoring range of motion, and improving shoulder function. It typically involves a combination pain management, physiotherapy, heat or cold treatment and manual therapy.
When is surgery needed?
When non-operative treatment has not been effective or you have noticed that your shoulder has not progressed in function over several months, surgery may be needed. This is usually done with minimally invasive surgery (arthroscopy) and manipulation under anaesthesia.
For Patients
It’s important to note that not all patients with frozen shoulder progress through these stages in a uniform manner. The duration and severity of each phase can vary, and some patients may experience overlapping or prolonged stages.
If you are experiencing shoulder pain and limited mobility from a frozen shoulder, book an appointment with Dr Arthur Turow at one of his clinic locations in Adelaide to discuss the right treatment for you.