Frozen shoulder


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When Frozen shoulder (English for "frozen shoulder") refer to doctors a disease of the shoulder joint capsule. The sufferers initially have severe shoulder pain, which gradually subside, while the shoulder becomes stiffer at the same time. This shoulder stiffness can spontaneously resolve after years. Read about the cause, symptoms and diagnosis of Frozen Shoulder, exercises and other therapies!

Article overview Frozen Shoulder
  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

Frozen Shoulder: Description

Frozen Shoulder is a disease of the shoulder joint capsule and very often the cause of shoulder pain and stiff shoulders. It is also referred to as adhesive capsulitis - a shoulder capsule inflammation associated with adhesions and adhesions. Further names for this disease are humerocapsulitis adhaesiva, fibrous stiffened shoulder or fibrosa capsulitis.

In addition, the Frozen Shoulder (as "Periarthorpathia humeroscapularis ankylosans") also falls under the collective term periarthritis humeroscapularis or periarthropathia humeroscapularis (PHS) - a group of degenerative diseases in the shoulder area, which are associated with a usually painful movement restriction of the joint.

The Frozen Shoulder occurs mainly between the ages of 40 and 60 years, with women being affected more frequently than men.

Primary and secondary shoulder stiffness

Physicians distinguish between a primary and a secondary form of Frozen Shoulder:

  • Primary (idiopathic) Frozen Shoulder: independent disease that can not be attributed to any existing underlying disease. Most widely used.
  • Secondary Frozen Shoulder: Result of other illnesses, injuries or operations in the shoulder area. Less common than the primary frozen shoulder.
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Frozen Shoulder: Symptoms

The Frozen Shoulder often runs in phases characterized by different symptoms:

Phase 1 - Freezing Shoulder

The disease usually begins with sudden, severe shoulder pain, which are initially movement-dependent. Gradually, they develop into constant pain, which also occurs in peace - especially at night, they are noticeable.

The pain is triggered by an unspecific inflammation of the synovial mucosa (synovitis) and the capsule structures. As a result of this inflammation, adhesions and adhesions form in the joint and the joint capsule shrinks. This increasingly affects the mobility of the shoulder. This phase of "freezing" the shoulder generally lasts about four months.

Phase 2 - Frozen Shoulder

The second phase of Frozen Shoulder generally runs from the 4th to the 8th month. Pain occurs only at the beginning. The main symptom is now the stiff shoulder - the movement restriction of the joint reaches its peak.

Phase 3 - "Thawing Shoulder"

In many cases Frozen Shoulder begins to "thaw" slowly from about the 8th month. The sufferers are barely in pain, the shoulder slowly loses its stiffness. It can take months or years until the shoulder is fully mobile again. In general, this is only possible with the right therapy.

The times for the duration of the individual phases are only general. In individual cases, the phases can last differently long. There are also patients in whom Frozen Shoulder's disease process continues for more than ten years. In some cases, the healing process is completely over.

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Frozen Shoulder: causes and risk factors

The cause of the primary frozen shoulder is unknown.

Possible causes of secondary shoulder stiffness are:

  • Injuries or diseases in the shoulder area such as a rupture of the rotator cuff (rotator cuff tear) or a painful entrapment of tendons or muscles in the shoulder joint (impingement syndrome)
  • Operations in the shoulder area
  • neurological causes such as a peripheral nerve disease, Parkinson's disease or irritation / damage of nerve roots (radiculopathy)
  • Metabolic diseases such as diabetes mellitus, Addison's disease (disease of the adrenal cortex) or thyroid disease

A Frozen Shoulder also occasionally develops in patients taking sedatives from the group of barbiturates or psychotropic drugs (remedies for mental illness).

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Frozen Shoulder: examinations and diagnosis

The first point of contact for suspected Frozen Shoulder and other shoulder pain is the family doctor. He can refer you to an orthopedist or shoulder specialist.

The doctor first asks you in detail about your complaints and your medical history (anamnesis). Possible questions are:

  • Since when do you have shoulder pain?
  • Are you often aroused by the pain at night?
  • Did you have an accident, injury or shoulder surgery?
  • What do you do for a living?

In the next step, the physical examination follows, whereby the doctor checks, among other things, the mobility of the shoulder.

X-ray examination of the shoulder does not give a specific result with a Frozen Shoulder. That is, the underlying changes of the disease are not visible in an X-ray. Nevertheless, the recording is useful to exclude other causes of shoulder pain such as a bone fracture, calcification or osteoarthritis.

Using ultrasound and magnetic resonance imaging (MRI), the physician can more accurately assess various structures in the shoulder joint (such as thickened ligaments or capsule portions), which can help diagnose Frozen Shoulder.